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NPI Code Detail

MEDICARE: DR. JOSE BOSE PSYD

MEDICARE: DR. JOSE BOSE PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY35819CA

General Provider Information

NPI Number : 1902990039
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE BOSE PSYD
Provider Business Mailing Address
First Line : 7707 AUSTIN RD
Second Line :
City : STOCKTON
State : CA
Zip : 95215-8312
Country : US
Telephone Number : 209-467-8638
Fax Number :
Provider Business Practice Location Address
First Line : 7707 AUSTIN RD
Second Line :
City : STOCKTON
State : CA
Zip : 95215-8312
Country : US
Telephone Number : 209-467-8638
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 02/01/2026

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Directions to “ DR. JOSE BOSE PSYD” Practice Location

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