DR. JACKIE A BOLDS (NPI# 1356497101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356497101 |
| Entity Type | Individual |
| Full Name | DR. JACKIE A BOLDS |
| Practice Address |
6066 Civic Terrace Ave Newark CA 94560 |
| Mailing Address |
Po Box 10285 Oakland CA 94610 |
| Practice Telephone | 5105051600 |
| Practice Fax Number | 5104947240 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
G57227 | CA | Ambulatory Health Care Facilities |
| Street Address |
6066 CIVIC TERRACE AVE |
| City | NEWARK |
| State | CA |
| Zip Code | 94560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316093362 | Peter Kusnierczyk | Nurse Practitioner | 6066 Civic Terrace Ave, Newark, CA 94560-3746 | 2007-01-25 |
| 1770113110 | Anh V Pham | Registered Nurse | 6066 Civic Terrace Ave, Newark, CA 94560-3746 | 2020-01-24 |
| 1497215362 | Tishu Sharma | Registered Nurse | 6066 Civic Terrace Ave, Newark, CA 94560-3746 | 2019-03-25 |
| 1063972974 | Tejinder Kaur Khaira | Registered Nurse | 6066 Civic Terrace Ave, Newark, CA 94560-3746 | 2019-03-25 |
| 1487110623 | Maria Guadalupe Jimenez | Registered Nurse | 6066 Civic Terrace Ave, Newark, CA 94560-3746 | 2019-02-12 |
| 1538610290 | Alameda Health System | Specialist | 6066 Civic Terrace Ave, Newark, CA 94560-3746 | 2016-10-18 |
| 1346577384 | Deepika Jannapureddy | Family Medicine | 6066 Civic Terrace Ave, Newark, CA 94560 | 2009-11-12 |
| 1689875478 | Alameda Health System | Clinic/Center | 6066 Civic Terrace Ave, Newark, CA 94560-3746 | 2007-05-30 |
| 1497956288 | Alameda Health System | Clinic/Center | 6066 Civic Terrace Ave, Newark, CA 94560-3746 | 2007-05-30 |
| 1821207796 | Stefanie T. Chu | Internal Medicine | 6066 Civic Terrace Ave, Newark, CA 94560-3746 | 2007-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538713086 | Newark Square Dental Care Inc | Dentist | 5678 Thornton Ave., Newark, CA 94560 | 2019-08-01 |
| 1942788971 | Evelyn Ibanez | Behavioral Analyst | 35201 Lido Blvd, Newark, CA 94560 | 2018-08-01 |
| 1851892954 | Chito Pascual | Nurse Practitioner | 7600 Gateway Blvd., Newark, CA 94560 | 2018-02-23 |
| 1700295466 | Juan Emanuel Tan Santos | Dentist | 5270 Newpark Mall Road, Newark, CA 94560 | 2014-08-07 |
| 1063761146 | Sarah Larae Devoe Scribner | Physical Therapist | 5600 John Muir Road, Newark, CA 94560 | 2012-09-05 |
| 1285983858 | Louie Crespo Ortiz-luis | General Practice | 35455 Dumbarton Court, Newark, CA 94560 | 2012-08-29 |
| 1184932535 | Annie Thanh-yen Du | Psychologist | 3900 Newpark Mall Rd, Ste 300, Newark, CA 94560 | 2010-09-20 |
| 1083931836 | Susan Elizabeth Hanaburgh | Marriage & Family Therapist | 39899 Balentine Drive #212, Family Service of The Tri-cities, Newark, CA 94560 | 2010-05-03 |
| 1306098694 | Maria Isabelle Santos Tuohy | Dentist | 5270 Newpark Plaza, Newark, CA 94560 | 2008-10-17 |
| 1699955765 | Jaspreet Kaur Harika | Dentist | 39736 Cedar Blvd, Newark, CA 94560 | 2007-11-06 |
| Find all providers in zip 94560 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871890079 | Ewr Medport | Clinic/Center | 339 Brewster Rd, Ste 201, Newark, NJ 07114 | 2011-02-24 |
| 1326679218 | North Ward Behavioral Health Center LLC | Clinic/Center | 485-491 Mt Prospect Ave, Newark, NJ 07104 | 2020-01-29 |
| 1376006395 | Wecare Tlc- Kenneth Copeland Ministries | Clinic/Center | 14355 Morris Dido Rd, Newark, TX 76071-9501 | 2019-04-08 |
| 1295991735 | World Wide Physical and Massage Therapy | Clinic/Center | 86 Bloomfield Ave, Basement, Newark, NJ 07104-1905 | 2008-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649878117 | Cameron S Francis Md Inc | Clinic/Center | 1431 Camino Del Mar, Del Mar, CA 92014-2509 | 2020-10-15 |
| 1982211835 | Crossover Health Medical Group | Clinic/Center | 711 W 2nd St Ste A, San Bernardino, CA 92410-3262 | 2020-09-24 |
| 1982211843 | Crossover Health Medical Group | Clinic/Center | 5379 Hamner Ave Unit 801, Eastvale, CA 91752-1042 | 2020-09-24 |
| 1164039020 | Crossover Health Medical Group | Clinic/Center | 14329 Frederick St Ste 7-9, Moreno Valley, CA 92553-9003 | 2020-09-24 |
| 1104432673 | Aleracare Medical Group of California | Clinic/Center | 17777 Ventura Blvd Ste 220, Encino, CA 91316-3748 | 2020-09-21 |
| 1205447687 | Shawn Richard Oneill | Clinic/Center | 5979 Trotters Ln, Alta Loma, CA 91701-2644 | 2020-08-11 |
| 1134738032 | Healthworks Med Group of California A Medical Corporation | Clinic/Center | 2821 Scott Blvd Ste 2126, Santa Clara, CA 95050-2549 | 2020-07-27 |
| 1437767951 | Miro Health | Clinic/Center | 260 King St Unit 1505, San Francisco, CA 94107-6415 | 2020-07-21 |
| 1598383895 | Alacrity Patient Services, Inc. | Clinic/Center | 1002 N Hudson Ave Apt 1, Los Angeles, CA 90038-2595 | 2020-07-13 |
| 1306464979 | Aleracare Medical Group of California | Clinic/Center | 4849 Van Nuys Blvd Ste 220, Sherman Oaks, CA 91403-2155 | 2020-07-10 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. JACKIE A BOLDS.
| 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.