Provider Demographics
NPI:1962857722
Name:BOYD, JOLEE (LMFT)
Entity Type:Individual
Prefix:
First Name:JOLEE
Middle Name:
Last Name:BOYD
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 22821
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-5821
Mailing Address - Country:US
Mailing Address - Phone:650-255-9583
Mailing Address - Fax:
Practice Address - Street 1:401 ROLAND WAY STE 150
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-2027
Practice Address - Country:US
Practice Address - Phone:501-839-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109567106H00000X
CA90526390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist