Individual
AGNES BOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, RN
Contact information
Practice address
506 S SPRING ST UNIT 13308, LOS ANGELES, CA 90013-3215
(903) 833-4363
Mailing address
506 S SPRING ST UNIT 13308, LOS ANGELES, CA 90013-3215
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95037172
CA
Other
Enumeration date
10/03/2025
Last updated
10/03/2025
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