Provider Demographics
NPI:1083370753
Name:BOREMAN, MARIA THERESE
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:THERESE
Last Name:BOREMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21651 FOOTHILL DR
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-8943
Mailing Address - Country:US
Mailing Address - Phone:661-300-0900
Mailing Address - Fax:
Practice Address - Street 1:21651 FOOTHILL DR
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-8943
Practice Address - Country:US
Practice Address - Phone:661-300-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376J00000XNursing Service Related ProvidersHomemaker