Maya Anjanette Bohannon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

125561 Issued in CA

Practice address

6051 N Fresno St Ste 201
Fresno, CA 93710-5280

Phone

(559) 248-8550

NPI assigned

Sep 3, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• 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.

• Spring to Autumn Family Counseling, Inc.

  • Marriage & Family Therapist
  • Redlands, CA
  • NPI 1689056442
  Medicare reassignment NPD

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1194339457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6051 N FRESNO ST STE 201",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 N FRESNO ST STE 201",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105280",
            "telephone_number": "559-248-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "MAYA",
        "middle_name": "ANJANETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "97392",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "125561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Diane Bogard, R.D.
• Lelia Marguerite Bogard, MFT
• Casandra Kay Bogart, RN
• Jimmie S Bogdanovich
• Robert Lee Bohanna, A.S.
• Michanne E Bohanon
• Michael P Bohigian, DC
• Michael Bohn, DDS
• Danielle Marlene Bohna
• Savannah Bohna

• Clinical Social Worker in Fresno, CA
• Providers in Fresno, 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 Sep 3, 2024; 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.