DEIDRA CHERIE BOLTON - NPI 1174711212 - Counselor in Oakland, CA

Q: What is Deidra Bolton's NPI number?

The NPI number for Deidra Bolton is 1174711212. It was assigned to this individual provider in the NPPES registry on October 12, 2007.

Q: What is Deidra Bolton's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Deidra Bolton was last updated on October 12, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Deidra Cherie Bolton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEIDRA CHERIE BOLTON (NPI 1174711212) is an individual mental health provider in Oakland, California and active in the NPI registry since October 2007.

NPPES Registry Identity

NPI1174711212

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameDEIDRA CHERIE BOLTON

Location Address4321 TOMPKINS AVEOakland, CA 94619-2820

Mailing Address4321 Tompkins AveOakland, CA 94619-2820 · (510) 715-4082

Phone(510) 715-4082

Sole ProprietorNo

Enumeration DateOctober 12, 2007

✔ NPI 1174711212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

4321 TOMPKINS AVE, Oakland, CA 94619

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Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANTHONY PATTON

Counselor (Mental Health)