Individual
JEANE BOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
795 WILLOW RD, MENLO PARK, CA 94025-2539
(415) 370-5352
Mailing address
PO BOX 602045, SAN DIEGO, CA 92160-2045
(858) 634-0125
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY30821
CA
Other
Enumeration date
04/11/2019
Last updated
04/30/2019
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