Bobby N. Holstead, PHD, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

214 Issued in NM

Legal business name

BOBBY N. HOLSTEAD, PHD, LLC

Practice address

9426 Indian School Rd NE
Suite 1
Albuquerque, NM 87112-2887

Phone

(505) 344-9500

Fax

(866) 808-7651

NPI assigned

Mar 6, 2007

Organization subpart

No

Name

Bobby N. Holstead, PH.D.

Title

Owner

Phone

(505) 344-9500

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Charles Ericson, PHD

  • Psychologist
  • Los Ranchos de Albuquerque, NM
  • NPI 1275547440
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 8, 2014.

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1962532648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 FAIRWAY RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871075720",
            "telephone_number": "505-344-9500",
            "fax_number": "866-808-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9426 INDIAN SCHOOL RD NE",
            "address_2": "SUITE 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122887",
            "telephone_number": "505-344-9500",
            "fax_number": "866-808-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOBBY N. HOLSTEAD, PHD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "HOLSTEAD",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-344-9500",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NM",
            "license": "214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N6176",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kofi Boateng
• Theresah Boateng, BCBA
• Jon Michael Boatman, RDH
• Koh Boayue, MD
• Bobbi Ebsen Psychotherapy LLC
• Jason Ryan Boberg
• Jackie Bocanegra
• Kimberly A Bocaz, CNP
• Bocephus Recovery Corp
• Edward S Bocian Jr., MD

• All providers in Albuquerque, NM
• Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.