Provider Information

Last Updated : Nov 21 2024 4:24 PM

Christopher Boldt




City
Fresno
Group
HEALTH NET DIRECT FFS MEDI-CAL
Specialty
Qualified Autism Svc Provider
Last Name
Boldt
First Name
Christopher
Address
7088 N Maple Ave Ste 105
State
CA
Zip Code
93720
Phone
(855)295-3276
Hours
Mon - Fri 8:00 AM - 5:00 PM Sat 8:00 AM - 3:00 PM
Gender
M
Title
BCBA
Physician ID
229919
Section Number
A
County
FRESNO
Accepting New Patient
Yes
PPG NAME
HEALTH NET DIRECT FFS MEDI-CAL
PPG ID
MHDML
NPI Number
1649636069
Access Requirement
Limited
PARKING_IND
P
EXT_BUILD_IND
EB
INT_BUILD_IND
IB
RESTROOM_IND
R
License ID
UNK52095
Email
credentialing@pacificchild.com
Board Certified
No
Self Access Flag
Self Reported Data
Panel Status
Available by referral only
PHY CCT IND
N

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