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DR. JEREMY VINCENT BOLTON PH.D.
NPI 1215789276
Psychologist - Clinical in Fresno, CA

Active since April 03, 2024PECOS EnrolledAccepts Medicare Assignment
516 W SHAW AVE, FRESNO, CA 93704(559) 803-9613 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jeremy Vincent Bolton Ph.d. NPPES

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

DR. JEREMY VINCENT BOLTON PH.D. (NPI 1215789276) is an individual clinical provider in Fresno, California, licensed in California (PSY36084) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1215789276
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JEREMY VINCENT BOLTONCredential: PH.D.
Location Address516 W SHAW AVEFresno, CA 93704-2515
Mailing Address516 W Shaw AveFresno, CA 93704-2515 · (559) 803-9613
Phone(559) 803-9613
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateApril 3, 2024
Last NPPES UpdateOctober 28, 2025
NPPES CertifiedOctober 28, 2025
✔ NPI 1215789276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in CA · PSY36084✔ Licensed in IA · 122557
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
516 W SHAW AVE, Fresno, CA 93704
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jeremy Vincent Bolton Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810474384
PECOS Enrollment IDI20260127002126
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93704 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$176.60 typical visit price
range $58.87 – $176.60
Typical copayment $44.15 (range $14.71 – $44.15)
Most-billed visit code 99205
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

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

GREGORY SUMII
Counselor (Mental Health)
516 W SHAW AVE
FRESNO, CA 93704
Fresno County (559) 221-4988
THE LEAD INSTITUTE, INC.
Psychologist (Clinical)
516 W SHAW AVE, SUITE 200
FRESNO, CA 93704
Fresno County (559) 221-4948
DR. BRIAN OLOWUDE PHD
Psychologist
516 W SHAW AVE, SUITE 200
FRESNO, CA 93704
Fresno County (559) 221-2571
DR. VIRGINIA JOHNSON
Psychologist (Clinical)
516 W SHAW AVE
FRESNO, CA 93704
Fresno County (559) 221-4948
OLFORD-EDDY PSYCHOLOGICAL SERVICES
Counselor (Mental Health)
516 W SHAW AVE, SUITE 200
FRESNO, CA 93704
Fresno County (559) 221-4988
DR. RAYMOND CHARLES DANIEL GREER PHD
Psychologist
516 W SHAW AVE, SUITE NUMBER 200 ATTN PERSONA NEUROBEHAVIOR GROUP
FRESNO, CA 93704
Fresno County (559) 269-4852
VASQUEZ CLINICAL SERVICES
Community/Behavioral Health
516 W SHAW AVE, SUITE 200
FRESNO, CA 93704
Fresno County (559) 221-2571

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeremy Bolton's NPI number?

The NPI number for Jeremy Bolton is 1215789276. It was assigned to this individual provider in the NPPES registry on April 3, 2024.

Where is Jeremy Bolton located?

Jeremy Bolton practices at 516 W Shaw Ave, Fresno, CA 93704. The listed phone number is (559) 803-9613.

What is Jeremy Bolton's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jeremy Bolton enrolled in Medicare?

Yes. Jeremy Bolton is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jeremy Bolton was last updated on October 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.