Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jeremy Vincent Bolton, PHD

Individual provider Clinical Psychologist · NPI 1215789276

Dr. Jeremy Vincent Bolton, PHD is a Clinical Psychologist in Fresno, California. Qualified in 2019, 7 years ago. Practices with Ehab Yacoub MD Inc, a 175-clinician group and accepts Medicare assignment. Licensed in California and Iowa.

Years since qualifying
7
Licensed in
CA, IA
In the registry since
2024
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

516 W Shaw Ave
Fresno, CA 93704-2515
Phone: (559) 803-9613
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY36084 (CA)
Clinical Psychologist Taxonomy 103TC0700X · Licence 122557 (IA)

Record details

NPI number1215789276
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedApril 3, 2024
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Ehab Yacoub Md Inc — 175 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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