| Doctor Name: | WESLEY A BOSCH |
| NPI Number: | 1396110391 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A., L.M.F.T. |
| License Number: | LMFT16179 |
| Business Practice Address: | 25283 Cabot Rd Suite 204 Laguna Hills, CA - 926535522 |
| Business Phone Number: | 9493574207 |
| Business Fax Number: | |
| Mailing Address: | 24331 Muirlands Blvd, No. D4-123 LAKE FOREST |
| State: | CA |
| Postal Code: | 926303688 |
| Phone Number: | 9493574207 |
| Fax Number: | |
| NPI Enumeration Date: | 12/02/2015 |
| NPI Last Update Date: | 04/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | LMFT16179 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |