Individual
JOSHUA BOLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2020 IOWA AVE, RIVERSIDE, CA 92507-0520
(951) 580-1026
Mailing address
555 N PERRIS BLVD BLDG A, PERRIS, CA 92571-2811
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
03/10/2021
Last updated
06/11/2025
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