DR. LINDA J BOUCHARD (NPI# 1275569352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275569352 |
| Entity Type | Individual |
| Full Name | DR. LINDA J BOUCHARD |
| Credential | M.D. |
| Practice Address |
1234 E North St Suite 102 Manteca CA 95336 |
| Mailing Address |
Po Box 1090 Lodi CA 95241-1090 |
| Practice Telephone | 2098242202 |
| Practice Fax Number | 2098242205 |
| Mailing Telephone | 2093341800 |
| Mailing Fax Number | 2093341430 |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2008-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | G58369 | CA | Other Service Providers |
| Y | 207V00000X | Obstetrics & Gynecology | G58369 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G58369 | 05 | |
| CA | GROUP NPI | 1386636165 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336508985 | Linda Marie Bouchard | Adult Companion | 76 Florence St, Tiverton, RI 02878-2421 | 2016-02-10 |
| Street Address |
1234 E NORTH ST SUITE 102 |
| City | MANTECA |
| State | CA |
| Zip Code | 95336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477530236 | Yong L Shih | Surgery | 1234 E North St, Suite 105, Manteca, CA 95336-4960 | 2005-12-22 |
| 1659715639 | First Choice Physician Partners | Orthopaedic Surgery | 1234 E North St, # 103, Manteca, CA 95336-4960 | 2013-04-22 |
| 1760724637 | First Choice Physician Partners | Orthopaedic Surgery | 1234 E North St, Ste 103, Manteca, CA 95336-4960 | 2013-03-19 |
| 1033475678 | Jack Andrew Harvey | Podiatrist | 1234 E North St, Ste 106, Manteca, CA 95336-4961 | 2012-04-09 |
| 1063688299 | Renee Jeanne Lee | Nurse Practitioner | 1234 E North St, Suite 102, Manteca, CA 95336-4960 | 2008-05-07 |
| 1063682169 | Eugene V. Nguyen, M.d., Inc | Family Medicine | 1234 E North St, Ste 106, Manteca, CA 95336-4960 | 2008-03-04 |
| 1427263516 | Eugene V Nguyen | Family Medicine | 1234 E North St, Ste 106, Manteca, CA 95336-4960 | 2007-05-11 |
| 1063596625 | Abbas Kashani Md Inc | Otolaryngology | 1234 E North St, 202, Manteca, CA 95336-4960 | 2006-10-24 |
| 1578653028 | Tonja Lynette Harris-stansil | Specialist | 1234 E North St, Ste. 102, Manteca, CA 95336-4960 | 2006-10-13 |
| 1871698993 | Jeffrey O Mcgillicuddy | Orthopaedic Surgery | 1234 E North St, Suite 103, Manteca, CA 95336-4960 | 2006-09-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225687676 | Kasside Sahagun-escalante | Behavior Technician | 402 Victory Ave, Manteca, CA 95336 | 2019-09-09 |
| 1295253797 | Adriana Pena | Counselor | 129 E.center Street Ste.3, Manteca, CA 95336 | 2017-09-05 |
| 1104352277 | Native Directions Inc. | Substance Abuse Rehabilitation Facility | 13505 Union Rd, Manteca, CA 95336 | 2017-05-10 |
| 1437508389 | Anna Gavin | Contractor | 1256 W. Lathrop Rd #376, Manteca, CA 95336 | 2016-06-10 |
| 1164826137 | Michael M. Catz, M.d., Inc | Anesthesiology | 1205 E. North Street, Manteca, CA 95336 | 2014-10-20 |
| 1033518923 | Leanne Louis | Community Health Worker | 129 E Center Street, #3, Manteca, CA 95336 | 2014-08-18 |
| 1255684122 | Kenneth S. Ching, Md., Inc | Anesthesiology | 1205 East North Street, Manteca, CA 95336 | 2012-10-17 |
| 1629323043 | Harpradeep Ratia | Dentist | 1332 E Yosemite Ave, Manteca, CA 95336 | 2012-07-23 |
| 1750643664 | Shelley Marie Kohl | Specialist/Technologist, Other | 425 E. Center St Suite 1, Manteca, CA 95336 | 2012-06-15 |
| 1932488038 | Valerie Diane Segura | Behavioral Analyst | 1882 Cherrywood Pl, Manteca, CA 95336 | 2011-08-08 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952491987 | George R Kunhardt | Obstetrics & Gynecology | 1191 E Yosemite Ave Ste C, Manteca, CA 95336-5071 | 2006-10-13 |
| 1053420489 | Kelly Mah | Obstetrics & Gynecology | 421 E Center St, Manteca, CA 95336-4718 | 2006-08-30 |
| 1942288873 | George C Scott | Obstetrics & Gynecology | 210 N Fremont St, Manteca, CA 95336-4725 | 2005-12-30 |
| 1447543160 | Gail R Joseph | Obstetrics & Gynecology | 1262 E North St, Manteca, CA 95336-4962 | 2011-05-27 |
| 1366516676 | Yu-yea M. Tzeng | Obstetrics & Gynecology | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2006-11-20 |
| 1770661589 | Jon G. Lee | Obstetrics & Gynecology | 1721 W Yosemite Ave, Manteca, CA 95337-5130 | 2006-11-01 |
| 1477654341 | Kelly Mah, M.d. | Obstetrics & Gynecology | 421 E Center St, Manteca, CA 95336-4718 | 2006-09-25 |
| 1992819957 | Prayuk A. Waran | Obstetrics & Gynecology | 1262 E North St, Manteca, CA 95336 | 2006-08-18 |
| 1093748006 | Cynthia M Vanata | Obstetrics & Gynecology | 1144 Norman Dr, #104, Manteca, CA 95336-5925 | 2006-07-10 |
| 1831122316 | Athena Medical Center for Women, Inc | Obstetrics & Gynecology | 321 Cherry Ln, Manteca, CA 95337-4355 | 2006-07-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.