Jack Roy Bohanon, MFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MFC29822 Issued in CA

Practice address

703 Welch Rd
Ste. F6
Palo Alto, CA 94304-1710

Phone

(650) 599-2262

Fax

(650) 625-1551

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1508947706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 GLADYS AVE",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940433967",
            "telephone_number": "650-599-2262",
            "fax_number": "650-625-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 WELCH RD",
            "address_2": "STE. F6",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041710",
            "telephone_number": "650-599-2262",
            "fax_number": "650-625-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANON",
        "first_name": "JACK",
        "middle_name": "ROY",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC29822",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC29822",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Christine Boehm, CTRS
• Yuk Boekenoogen
• Alina Margaret Boelman, M.D.
• Charmayne Alexandra Boeving Allen, PHD
• John Boggs, M.D.
• Sean Patrick Bohen, M.D., PH.D.
• Cara Bohon, PH.D.
• Jack L Bois Jr., D.P.M.
• Allison Suzanne Boissevain, OTR/L
• Alexis Denise Bolds, MD

• Mental Health Counselor in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.