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General NPI Number Information
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NPI Number | 1558489138
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Entity Type | Individual
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Provider Name | JOHN C BOLF PHD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 101 CIRBY HILLS DR
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City | ROSEVILLE
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State | CA
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Zip | 95678-4360
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Country | US
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Telephone | 916-787-8814
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Fax | 916-787-8967
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Provider Business Mailing Address
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Address Line | 10556 COMBIE RD P. O. BOX 106525
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City | AUBURN
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State | CA
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Zip | 95602-8908
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Country | US
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Telephone | 916-787-8814
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Fax | 916-787-8967
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY6653
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT13752
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License Number State | CA
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