Provider Demographics
NPI:1245773217
Name:BOSS, RHONDA (LMFT)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:BOSS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6300
Mailing Address - Street 2:
Mailing Address - City:CRESTLINE
Mailing Address - State:CA
Mailing Address - Zip Code:92325-6300
Mailing Address - Country:US
Mailing Address - Phone:909-336-3330
Mailing Address - Fax:
Practice Address - Street 1:340 HWY 138
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:CA
Practice Address - Zip Code:92325-6300
Practice Address - Country:US
Practice Address - Phone:909-336-3330
Practice Address - Fax:951-300-4719
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT107847106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist