Provider Demographics
NPI:1568644078
Name:BOFFMAN, JUNE L (CPNP)
Entity Type:Individual
Prefix:DR
First Name:JUNE
Middle Name:L
Last Name:BOFFMAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3349 G ST STE F
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-0978
Mailing Address - Country:US
Mailing Address - Phone:209-349-8459
Mailing Address - Fax:
Practice Address - Street 1:3180 COLLINS DR STE A
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3156
Practice Address - Country:US
Practice Address - Phone:209-259-4301
Practice Address - Fax:209-354-4932
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201229363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics