Lenny Bolton, RADT I

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

5671 Churchward St
San Diego, CA 92114-4010

Phone

(619) 915-6452

NPI assigned

May 24, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Center for Positive Changes

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • San Diego, CA
  • NPI 1558109017
  NPD (past)
• NR Medical Associates

  • Pulmonary Disease Physician
  • San Diego, CA
  • NPI 1649601113
  NPD (past)

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1295300051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4526 ILLINOIS ST APT 10C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164375",
            "telephone_number": "217-778-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 CHURCHWARD ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921144010",
            "telephone_number": "619-915-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "LENNY",
        "credential": "RADT I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-24",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlee Bolt, PMHNP-BC
• Ryan Mabe Bolt, PMHNP-BC, FNP-C
• Alex Bolton, APRN
• Jessica L Bolton, PSY.D.
• Leanna Bolton
• Michelle Bolz
• Gentry Boman, SUDRC
• Rebecca Gray Boman, RN
• Allan T Bombard, MD
• Aspen Jewel Bombardo, AU.D.

• Rehabilitation Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; 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.