MR. JACK ROY BOHANON MFT NPI 1508947706

NPI Information

NPI: 1508947706
Provider Name: MR. JACK ROY BOHANON, MFT
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
703 WELCH RD
STE. F6
PALO ALTO, CA
ZIP 94304
Phone: (650) 599-2262
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MR. Jack Roy Bohanon, MFT is a mental health counselor in Palo Alto, CA. MR. Jack Roy Bohanon, MFT NPI is 1508947706. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

703 WELCH RD
STE. F6
PALO ALTO, CA
ZIP 94304-710
Phone: (650) 599-2262
Fax: (650) 625-1551

The enumeration date for this NPI number is 10/17/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	MFC29822	CALIFORNIA	Yes
2	106H00000X	Marriage & Family Therapist		MFC29822	CALIFORNIA	X

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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