Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1053268979 Individual Practitioner Female Practitioner

Carly Bourque

Counselor - School • Pine Valley, CA

Professional Overview & Biography Verified Profile Summary

Carly Bourque is a registered healthcare professional specializing in Counselor - School in Pine Valley, CA. Practice services are available at 3305 BUCKMAN SPRINGS RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3305 Buckman Springs Rd

Pine Valley, CA 919624005

Telephone 6193266662

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - School in Pine Valley, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 6.5 Yrs
Regional Practice Density
2 Specialists

Practicing in Pine Valley, CA (2910 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-03-11
Counselor - School Primary Specialty

NUCC Taxonomy Code: 101YS0200X

State License CA 220102083

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Trishauna Pulos

Health & Wellness Coach

NPI 1013846104
Christina Crane , PPS

Counselor - School

NPI 1285597328
Gary Brannon

Health & Wellness Coach

NPI 1487515789
NPI 1619830742

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active March 11, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location March 11, 2026

Registered at 3305 BUCKMAN SPRINGS RD, PINE VALLEY, CA 919624005 (Tel: 6193266662)

📍
Updated Business Mailing Address March 11, 2026

Registered at 3305 BUCKMAN SPRINGS RD, PINE VALLEY, CA 919624005

👤
Provider Name / Credentials Updated March 11, 2026

Recorded as CARLY BOURQUE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 11, 2026

Counselor (License #220102083 in CA)

🟢
Initial NPI Registration & Enumeration March 11, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053268979
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 11, 2026
Last Update: March 11, 2026
Sole Proprietor: No

Mailing Address

3305 Buckman Springs Rd

Pine Valley, CA 919624005

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.