Provider Demographics
NPI:1902087919
Name:BOLDEN, FELICIA D
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:D
Last Name:BOLDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W TEMPLE ST
Mailing Address - Street 2:9TH FLOOR-HALL OF RECORDS
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3208
Mailing Address - Country:US
Mailing Address - Phone:213-974-0530
Mailing Address - Fax:213-620-1405
Practice Address - Street 1:320 W TEMPLE ST
Practice Address - Street 2:9TH FLOOR-HALL OF RECORDS
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3208
Practice Address - Country:US
Practice Address - Phone:213-974-0530
Practice Address - Fax:213-620-1405
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor