Individual
JOHN BOUDREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 COLUMBIA AVE, LOS ANGELES, CA 90017-1209
(213) 368-1888
(213) 368-6888
Mailing address
515 COLUMBIA AVE STE 515, LOS ANGELES, CA 90017-1209
(213) 553-1800
(213) 368-1366
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
06/05/2015
Last updated
05/07/2025
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