Doctor Name: | MR. JAMES SAMUEL BOLDT |
NPI Number: | 1033258215 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S.W. |
License Number: | LCS 5728 |
Business Practice Address: | 344 Lupine Way Ventura, CA - 930012221 |
Business Phone Number: | 8056434357 |
Business Fax Number: | |
Mailing Address: | 344 Lupine Way, VENTURA |
State: | CA |
Postal Code: | 930012221 |
Phone Number: | 8056434357 |
Fax Number: | |
NPI Enumeration Date: | 02/05/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCS 5728 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |