1629350079 NPI number — NANCY K BOHL, INC

Table of content: (NPI 1629350079)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629350079 NPI number — NANCY K BOHL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NANCY K BOHL, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE COUNSELING TEAM INTERNATIONAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629350079
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10427
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN BERNARDINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92423-0427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-884-0133
Provider Business Mailing Address Fax Number:
909-384-0734

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1881 BUSINESS CENTER DR STE 11
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN BERNARDINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92408-3438
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-884-0133
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/12/2011

Additional Information

Authorized Official

Authorized Official Last Name:
KOOT
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
909-884-0133

Provider Taxonomy Codes

  • Taxonomy code: 305R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1184040222 . This is a "JULIE RATHBUN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1265854665 . This is a "ANGELA RONAN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1164813374 . This is a "AMANDA STEIGER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1407124761 . This is a "KATHLEEN WELLBROCK" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1962688796 . This is a "WISCONSIN STURM" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1548353873 . This is a "DEBORAH SILVERIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1578903175 . This is a "ANDREW CLACK" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1922425776 . This is a "CHRISTA WALLIS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1497172001 . This is a "SARAH WILKINSON" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1780872168 . This is a "ANGELIKA ROBINSON" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1851701197 . This is a "JAMES DONCKELS" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1134488265 . This is a "DEANA KAHLE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 1629350079 . This is a "NANCY BOHL-PENROD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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