Karen A Boltwood

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

53088 Issued in CA

Practice address

2020 Coffee Rd Ste A5
Modesto, CA 95355-2407

Phone

(209) 248-5505

Fax

(855) 821-1966

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1376663161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 COBBLESTONE CIR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554501",
            "telephone_number": "209-572-0511",
            "fax_number": "209-526-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 COFFEE RD STE A5",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552407",
            "telephone_number": "209-248-5505",
            "fax_number": "855-821-1966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 McHenry Village Way # 11",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953504308",
            "country_code": "US",
            "telephone_number": "209-526-1476",
            "fax_number": "209-526-0908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLTWOOD",
        "first_name": "KAREN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "53088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ranti Sherifat Bolaji, MD
• Collage Alexandrea Bolden
• Bryan Bolduc, CATC II
• Matty Bollen
• Chester McBride Boltwood Jr., MD
• Bijan Bonakdar, DO
• Maya Bondad
• Tracy Lynne Bondi, NP
• Emily Anne Bonds
• Andrea Marie Bonetti, OTR/L

• Marriage & Family Therapist in Modesto, CA
• Providers in Modesto, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.