Provider Demographics
NPI:1679822480
Name:BOHLMANN, GENE L (EDD)
Entity Type:Individual
Prefix:
First Name:GENE
Middle Name:L
Last Name:BOHLMANN
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12501 SEAL BEACH BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-8815
Mailing Address - Country:US
Mailing Address - Phone:562-240-7780
Mailing Address - Fax:310-540-1229
Practice Address - Street 1:4281 KATELLA AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3500
Practice Address - Country:US
Practice Address - Phone:714-226-9770
Practice Address - Fax:714-226-9776
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46279106H00000X
CAPSY27893103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist