Jack Roy Bohanon in Mountain View - Marriage & Family Therapist
Jack Roy Bohanon - NPI 1508947706
Jack Roy Bohanon is a Marriage & Family Therapist in Mountain View, California. Jack Roy Bohanon practices all healthcare services and medical treatments related to Marriage & Family Therapist. The NPI Number for Jack Roy Bohanon is 1508947706. The last update date is 2007-07-08.
Jack Roy Bohanon's current location address is 123 Gladys Ave, Mountain View, California. You can contact this provider via phone number 6505992262 and fax number 6506251551. The mailing address for Jack Roy Bohanon is 123 Gladys Ave, Mountain View, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack Roy Bohanon |
|---|---|
| Address | 123 Gladys Ave, Mountain View, California |
| Phone Number | 6505992262 |
| Fax Number | 6506251551 |
| Sole Proprietor | Y |
| Credentials | MFT |
NPI Number Detail
| NPI Number | 1508947706 |
|---|---|
| Provider Enumeration Date | 2006-10-17 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 123 Gladys Ave |
|---|---|
| City | Mountain View |
| State | California (CA) |
| Post Code | 940433967 |
| Phone Number | 6505992262 |
| Fax Number | 6506251551 |
Provider's Primary Taxonomy Detail
| Speciality | Marriage & Family Therapist |
|---|---|
| Taxonomy | 106H00000X |
| Licence No | MFC29822 |
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Definition: A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives |
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What is the unique 10-digit identifier code assigned to Jack Roy Bohanon by the Centers for Medicare & Medicaid Services?
The Jack Roy Bohanon has been issued the NPI (National Provider Identifier) 1508947706 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Jack Roy Bohanon located?
The Jack Roy Bohanon is located at 123 Gladys Ave, Mountain View, CA 940433967.
What is Jack Roy Bohanon's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Jack Roy Bohanon is Marriage & Family Therapist, and the taxonomy code that classifies this field of practice is 106H00000X.
On what date did the Jack Roy Bohanon receive its 1508947706 assignment from the Centers for Medicare & Medicaid Services?
The Jack Roy Bohanon was assigned its 1508947706 by the Centers for Medicare & Medicaid Services on 2006-10-17.
When was the information regarding Jack Roy Bohanon most recently updated?
The details pertaining to the Jack Roy Bohanon, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
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