MR. JACK ROY BOHANON MFT NPI 1508947706

NPI Information

  • NPI: 1508947706
  • Provider Name: MR. JACK ROY BOHANON, MFT
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 703 WELCH RD
    STE. F6
    PALO ALTO, CA
    ZIP 94304
  • Phone: (650) 599-2262

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NPI Details

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 9/11/2025.

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
1101YM0800XCounselorMental HealthMFC29822CALIFORNIAYes
2106H00000XMarriage & Family TherapistMFC29822CALIFORNIANo

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: 11/21/2025

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