Individual provider · Type 1 NPI

Kevin Bouldin

Student in an Organized Health Care Education/Training Program · Santa Ana, CA

NPI number 1497521488 Active

Practice location

2130 E 4th St
Santa Ana, CA 92705-3818

Call (714) 543-5437 Map

Fax (999) 999-9999

Mailing address

15160 Teakwood St
Lake Elsinore, CA 92530-7321

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1497521488

Kevin Bouldin's National Provider Identifier is 1497521488, issued on Nov 30, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Santa Ana, CA. The record was last updated on Aug 26, 2026.