LAURA BOLLES
NPI 1235788308
Marriage & Family Therapist in San Rafael, CA

Q: What is Laura Bolles's NPI number?

The NPI number for Laura Bolles is 1235788308. It was assigned to this individual provider in the NPPES registry on September 10, 2019.

Q: What is Laura Bolles's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Laura Bolles was last updated on October 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.

Active since September 10, 2019PECOS Enrolled

111 SMITH RANCH RD, SAN RAFAEL, CA 94903(415) 250-6597 Get Directions Write a Review

NPPES record last updated: October 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 3, 2024, Jan 3, 2020, Sep 10, 2019 (3 updates tracked since 2019).

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About Laura Bolles NPPES

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

LAURA BOLLES (NPI 1235788308) is an individual marriage & family therapist in San Rafael, California, licensed in California (116963) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235788308

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameLAURA BOLLES

Location Address111 SMITH RANCH RDSan Rafael, CA 94903-1939

Mailing Address2275 Arlington DrSan Leandro, CA 94578-1132 · (510) 317-1444

Phone(415) 250-6597

Sole ProprietorNo

Enumeration DateSeptember 10, 2019

Last NPPES UpdateOctober 3, 20243 updates tracked since enumeration

NPPES CertifiedOctober 3, 2024

✔ NPI 1235788308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 116963

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

111 SMITH RANCH RD, San Rafael, CA 94903

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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 (PECOS)

Laura Bolles is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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Other Providers at the Same Location NPPES 20

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

STEPHANIE LOPEZ

Psychologist