Ryan Mabe Bolt, PMHNP-BC, FNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95008584 Issued in CA

Practice address

10620 Treena St Ste 230
San Diego, CA 92131-1140

Phone

(858) 609-9763

Fax

(504) 290-1145

NPI assigned

Feb 14, 2018

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment NPD
• Healthy Me Nursing, Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
  • NPI 1972221794
  Medicare reassignment NPD
• Ashlee Lauren Bolt Nursing Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Diego, CA
  • NPI 1609422286
  NPD

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1639679822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 TREENA ST STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311140",
            "telephone_number": "208-850-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 TREENA ST STE 230",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311140",
            "telephone_number": "858-609-9763",
            "fax_number": "504-290-1145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7830 Clairemont Mesa Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921111632",
            "country_code": "US",
            "telephone_number": "858-268-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLT",
        "first_name": "RYAN",
        "middle_name": "MABE",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC,  FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-14",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95008584",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008584",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Boller, CMT
• Kathryn B Bollin, M.D.
• Marlayna Danielle Bollinger
• Manuel Bolosan, LVN
• Ashlee Bolt, PMHNP-BC
• Alex Bolton, APRN
• Jessica L Bolton, PSY.D.
• Leanna Bolton
• Lenny Bolton, RADT I
• Michelle Bolz

• Psychiatric/Mental Health Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.