Individual provider · Type 1 NPI

Jack Roy Bohanon, MFT

Mental Health Counselor · Palo Alto, CA

NPI number 1508947706 Active

Practice location

703 Welch Rd, Ste. F6
Palo Alto, CA 94304-1710

Call (650) 599-2262 Map

Fax (650) 625-1551

Mailing address

123 Gladys Ave
Mountain View, CA 94043-3967

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XMFC29822 (CA)
Marriage & Family Therapist 106H00000XMFC29822 (CA)

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About NPI 1508947706

Jack Roy Bohanon, MFT's National Provider Identifier is 1508947706, issued on Oct 17, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Palo Alto, CA. The record was last updated on Sep 11, 2025.