Individual provider Active NPI

Roland Bolor

  • Adult Psychiatric/Mental Health Registered Nurse
  • Chula Vista, CA
National Provider Identifier
1467979898
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
95065025 Issued in CA
Practice address
330 Moss St
Chula Vista, CA 91911-2005
Phone
(619) 426-6310
NPI assigned
Aug 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 95065025 CA Primary

Addresses

Primary practice location

330 Moss St
Chula Vista, CA 91911-2005

Mailing address

13657 Freeport Rd
San Diego, CA 92129-3210

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

State licenses

LicenseStateTypeSpecialty
95065025CAMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1467979898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13657 FREEPORT RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921293210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MOSS ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919112005",
            "telephone_number": "619-426-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLOR",
        "first_name": "ROLAND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "95065025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2017; 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.