Individual
DR. JEANINE MARIE PONTES-BOELTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4141 GEARY BLVD, 4TH FLOOR, SAN FRANCISCO, CA 94118-3109
(415) 833-2292
Mailing address
710 S BROADWAY, WALNUT CREEK, CA 94596-5294
(209) 535-3501
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 22084
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY 22084
CALIFORNIA BOARD OF PSYCHOLOGY
CA
Enumeration date
08/13/2008
Last updated
11/06/2013
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