Individual provider Active NPI

Deborah Von Bolschwing, PH.D

  • Psychologist
  • Dillon Beach, CA
National Provider Identifier
1194989053
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSB355039 Issued in CA
Practice address
576 Oceana Drive
Dillon Beach, CA 94929
Phone
(707) 878-2446
NPI assigned
Jul 10, 2008
Last updated
Jul 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSB355039 CA Primary

Addresses

Primary practice location

576 Oceana Drive
Dillon Beach, CA 94929

Mailing address

PO Box 84
576 Oceana Drive
Dillon Beach, CA 94929
Phone (707) 878-2446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSB355039CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1194989053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84",
            "address_2": "576 OCEANA DRIVE",
            "city": "DILLON BEACH",
            "state": "CA",
            "postal_code": "94929",
            "telephone_number": "707-878-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 OCEANA DRIVE",
            "city": "DILLON BEACH",
            "state": "CA",
            "postal_code": "94929",
            "telephone_number": "707-878-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON BOLSCHWING",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB355039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.