| Bold Within Inc | |
|
257 W. Seventh St San Pedro CA 90731 | |
| (562) 477-5815 | |
| Not Available |
| Full Name | Bold Within Inc |
|---|---|
| Speciality | Social Worker |
| Location | 257 W. Seventh St, San Pedro, California |
| Authorized Official Name and Position | Dora I Ramirez (PRESIDENT) |
| Authorized Official Contact | 5624775815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bold Within Inc 257 W. 7th St San Pedro CA 90731 Ph: (562) 477-5815 | Bold Within Inc 257 W. Seventh St San Pedro CA 90731 Ph: (562) 477-5815 |
| NPI Number | 1942179783 |
|---|---|
| Provider Enumeration Date | 10/31/2025 |
| Last Update Date | 01/15/2026 |
| Certification Date | 01/15/2026 |
| Medicare PECOS PAC ID | 1557841574 |
|---|---|
| Medicare Enrollment ID | O20260217003887 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942179783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | () | Secondary |
| 1041C0700X | Social Worker - Clinical | () | Primary |
| 106H00000X | Marriage & Family Therapist | () | Secondary |
| Provider Name | Darin Lee Rorrer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912321472 PECOS PAC ID: 3678987757 Enrollment ID: I20210201002063 |
| Provider Name | John David Garcia |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1932703675 PECOS PAC ID: 6406354109 Enrollment ID: I20250812002216 |
| Provider Name | Dora Ramirez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669979274 PECOS PAC ID: 2466932488 Enrollment ID: I20260220003706 |
| Provider Name | Johanna Stephanie Jimenez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588952667 PECOS PAC ID: 9436632916 Enrollment ID: I20260312002195 |
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