Provider Demographics
NPI:1790123818
Name:NEWLAND, CASEY BOEHM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:BOEHM
Last Name:NEWLAND
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:ABIGAIL
Other - Last Name:BOEHM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-0674
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1950 ALAMEDA DE LAS PULGAS
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1222
Practice Address - Country:US
Practice Address - Phone:650-372-6114
Practice Address - Fax:650-572-9347
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist