Shelby H Bollenbacher, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW81137 Issued in CA

Practice address

1160 S Grand Ave
Glendora, CA 91740-5000

Phone

(626) 335-5980

Fax

(626) 335-5989

NPI assigned

Mar 31, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Campbell, CA
  • NPI 1255496105
  Medicare reassignment NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Glendale, CA
  • NPI 1366100851
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1134418007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405000",
            "telephone_number": "626-335-5980",
            "fax_number": "626-335-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405000",
            "telephone_number": "626-335-5980",
            "fax_number": "626-335-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLENBACHER",
        "first_name": "SHELBY",
        "middle_name": "H",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW81137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bliss Health Care Inc.
• Body 101
• Michael Bogey, M.D.
• Ryan Bohm, M.S., M.DIV
• Martin A. Bohorquez, M.D.
• David L Bolton, D.C.
• Bones Management, Inc.
• Brooke Kelly Bonilla, OD
• Christine Bou Sleiman, RDN
• Guadalupe Garcia Boudreaux, APCC

• Clinical Social Worker in Glendora, CA
• Providers in Glendora, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.