Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shady Boules, NP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1497123517

Shady Boules, NP is a Nurse Practitioner in Riverside, California. Qualified in 2025, 1 year ago. Practices with Ehab Yacoub MD Inc, a 175-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2015
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

16282 Skyridge Dr
Riverside, CA 92503-0562
Phone: (951) 722-0802
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4695 Macarthur Ct Ste 1100, Newport Beach, CA 92660-1866 — (949) 293-3440

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95037846 (CA)

Record details

NPI number1497123517
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorYes
NPI enumeratedSeptember 4, 2015
Last updated in NPPESDecember 25, 2025
Certification dateDecember 25, 2025
Mailing address16282 Skyridge Dr, Riverside, CA 92503-0562

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Ehab Yacoub Md Inc — 175 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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