Healthcare Provider Details

I. General information

NPI: 1992901599
Provider Name (Legal Business Name): NATALIYA A. BOLSHEVA PH.D. CFC, FABFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3522 GEARY BLVD # 4
SAN FRANCISCO CA
94118-2812
US

IV. Provider business mailing address

3522 GEARY BLVD. #4
SAN FRANCISCO CA
94118-2812
US

V. Phone/Fax

Practice location:
  • Phone: 415-759-8105
  • Fax: 415-759-8105
Mailing address:
  • Phone: 415-759-8105
  • Fax: 415-759-8105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: