Jonathan Bolanos

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

555 Technology CT
Riverside, CA 92507-2155

Phone

(951) 686-8500

NPI assigned

Jan 23, 2024

Last updated

Aug 18, 2025By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Olive Crest

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1316101322
  NPD
• Olive Crest

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1699946608
  NPD
• Olive Crest

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1215418165
  NPD (past)

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1952163289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 TECHNOLOGY CT STE 105",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072155",
            "telephone_number": "951-686-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 TECHNOLOGY CT",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072155",
            "telephone_number": "951-686-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOS",
        "first_name": "JONATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-23",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Renee Bokhari, NP
• Syed W Bokhari, M. D.
• Affa N Bokossah, LVN
• Kimberly Bolanos-Alcocer
• Alex Tristine Bolanos
• Roxanne Bolanos
• Victor Bolanos Jr.
• Kimia Boldaji, MD
• Joshua Bolen
• Sylvia Bolin, RPH

• Rehabilitation Practitioner in Riverside, CA
• Providers in Riverside, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.