Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jack Roy Bohanon, MFT

Individual provider Mental Health Counselor · NPI 1508947706

Mr. Jack Roy Bohanon, MFT is a Mental Health Counselor in Palo Alto, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MFT — Marriage and Family Therapist
A therapist who treats couples and families.

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Practice location Address checks out

703 Welch Rd Ste F6
Palo Alto, CA 94304-1710
Phone: (650) 599-2262
Fax: (650) 625-1551
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence MFC29822 (CA)
Marriage & Family Therapist Taxonomy 106H00000X · Licence MFC29822 (CA)

Record details

NPI number1508947706
Entity typeIndividual (Type 1)
GenderMale
Credentials MFT
Sole proprietorYes
NPI enumeratedOctober 17, 2006
Last updated in NPPESSeptember 11, 2025

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