Carolyn Virginia Bola, PSYD
Individual provider Active NPI Forensic Psychologist · Corcoran, CA
NPI 1427317700 · NPPES record last updated May 8, 2012
Key facts
- NPI
- 1427317700
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Forensic Psychologist 103TF0200X
- License
- PSY16230 (CA)
- Practice address
- 4001 King Ave
Corcoran, CA 93212 - Phone
- (559) 992-8800
- NPI assigned
- May 8, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16230 | CA | MD | Forensic Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past |
Accepting new patients | |
| CSP-Corcoran | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | PSY16230 | CA | Yes |
Addresses
Primary practice location
4001 King Ave
Corcoran, CA 93212
Mailing address
PO Box 948
Hanford, CA 93232-0948
Phone (559) 589-1361
Other providers in Corcoran, CA
- Jasper Fermell Basit
- Michael C Bean
- Helen Ann Becich
- Olga Beregovskaya
- Brittany Danielle Blowers
- Roberto Carlos Bonilla
- Harland Travis Boreen
- Jonathan Bradley
- Thomas James Burket II
- California Department of Corrections and Rehabiliations
All providers in Corcoran, CA · Forensic Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.