Basic Information
| Provider Information | |||||||||
| NPI: | 1245459544 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOLTER | ||||||||
| FirstName: | CINDY | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | PMHNP-BC, NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2740 GRANT ST | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945202265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256744159 | ||||||||
| FaxNumber: | 9256744141 | ||||||||
| Practice Location | |||||||||
| Address1: | 2740 GRANT ST | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945202265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256744159 | ||||||||
| FaxNumber: | 9256744141 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2007 | ||||||||
| LastUpdateDate: | 02/02/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SP0807X | RN336646 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health, Child & Adolescent | 363LF0000X | 17440 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0808X | 17440 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 163WP0808X | RN336646 | CA | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.