MR. CHARLES KEENE BULTMAN JR. MS
NPI 1265639231
Marriage & Family Therapist in Concord, CA

Q: What is Charles Bultman's NPI number?

The NPI number for Charles Bultman is 1265639231. It was assigned to this individual provider in the NPPES registry on July 2, 2007.

Q: What is Charles Bultman'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 Charles Bultman was last updated on January 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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 July 02, 2007PECOS EnrolledAccepts Medicare Assignment

2827 CONCORD BLVD, CONCORD, CA 94519(925) 695-0405 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Mr. Charles Keene Bultman Jr. Ms NPPES

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

MR. CHARLES KEENE BULTMAN JR. MS (NPI 1265639231) is an individual marriage & family therapist in Concord, California, licensed in California (50904) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1265639231

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameMR. CHARLES KEENE BULTMAN JR.Credential: MS

Location Address2827 CONCORD BLVDConcord, CA 94519-2608

Mailing Address4101 Macdonald AveRichmond, CA 94805-2333

Phone(925) 695-0405

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateJuly 2, 2007

Last NPPES UpdateJanuary 3, 2022

✔ NPI 1265639231 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 · 50904

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.

2827 CONCORD BLVD, Concord, CA 94519

Open in Google Maps ↗

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

Mr. Charles Keene Bultman Jr. Ms 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 ID3678086188

PECOS Enrollment IDI20250627003540

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.

Other Providers at the Same Location NPPES 11

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

DR. CYNTHIA LYNN-NOSS MATARASO PSYCHOLOGIST

Psychologist (Clinical)