DEREK MICHAEL BEAULIEU (NPI# 1376033043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376033043 |
| Entity Type | Individual |
| Full Name | DEREK MICHAEL BEAULIEU |
| Credential | MD |
| Practice Address |
450 Broadway Street Pavilion C, 2nd Floor - Mc5334 Redwood City CA 94063 |
| Practice Telephone | 6507236316 |
| Mailing Telephone | 6034012289 |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2019-08-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770937385 | Derek Beaulieu Sr. | Counselor | 1695 Main St, Springfield, MA 01103-1348 | 2016-04-20 |
| Street Address |
450 BROADWAY STREET PAVILION C, 2ND FLOOR - MC5334 |
| City | REDWOOD CITY |
| State | CA |
| Zip Code | 94063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144489592 | Jordan Lee Newmark | Anesthesiology | 450 Broadway Street, 1st Floor, Pav A, Redwood City, CA 94063 | 2008-06-02 |
| 1205318573 | Kate Lauren Kevorken | Physical Therapist | 450 Broadway Street, Pavilion B31, 3rd Floor, Redwood City, CA 94063 | 2018-09-04 |
| 1164872651 | Chris Alison Chou | Psychiatry & Neurology | 450 Broadway Street, Pavilion B, 2nd Floor, Mc 5730, Redwood City, CA 94063-1010 | 2016-06-15 |
| 1760875157 | Gloria Yi | Physical Therapist | 450 Broadway Street, Suite A24, M/c 6122, Redwood City, CA 94063 | 2015-03-10 |
| 1639596638 | Sara Nichole Raiser | Physical Medicine & Rehabilitation | 450 Broadway Street, Mc: 6342, Redwood City, CA 94063-3132 | 2014-03-27 |
| 1871939322 | Nisha Varadarajan | Internal Medicine | 450 Broadway Street, Pavilion C, Mc 5334, Redwood City, CA 94041 | 2013-05-10 |
| 1992020127 | Eleni Linos | Dermatology | 450 Broadway Street, Dept Dermatology, Pavillion C, 2nd Floor, Redwood City, CA 94063 | 2010-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578104378 | Jade Francetich | Psychologist | 450 Broadway St., Pavilion B 2nd Floor, Redwood City, CA 94063 | 2019-10-02 |
| 1861052060 | County of San Mateo | Clinic/Center | 1300 Maple St., Redwood City, CA 94063 | 2019-06-19 |
| 1750941977 | County of San Mateo | Clinic/Center | 300 Bradford St., Redwood City, CA 94063 | 2019-06-19 |
| 1023678661 | Linda K Watanabe | Preventive Medicine | 700 Bay Rd. #2803, Redwood City, CA 94063 | 2019-06-17 |
| 1235630369 | Waverly Place Apartments, Lp | Case Management | 105 Waverly Place, Redwood City, CA 94063 | 2018-02-23 |
| 1306371679 | Caely Alise Hambro | Student in an Organized Health Care Education/Training Program | Stanford Dermatology, 430 Broadway, Redwood City, CA 94063 | 2017-04-25 |
| 1609316736 | Justine Nicole Dela Cruz | Nurse Practitioner | 420 Broadway St # D, Redwood City, CA 94063 | 2017-03-08 |
| 1336683234 | Babita Chopra | Pharmacist | 2300 Middlefield Road, Redwood City, CA 94063 | 2016-12-12 |
| 1073065595 | Diana Genoveva Posner I | Counselor | 604 Prince Ave. Ste A, Redwood City, CA 94063 | 2016-11-01 |
| 1295288264 | Benjamin Dickter | Student in an Organized Health Care Education/Training Program | 1107 2nd Ave, Apt 103, Redwood City, CA 94063 | 2016-07-26 |
| Find all providers in zip 94063 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851908834 | Katharine Lorey | Student in an Organized Health Care Education/Training Program | 650 Scott Ave, Redwood City, CA 94063-2937 | 2020-09-24 |
| 1255941613 | Akash Goel | Student in an Organized Health Care Education/Training Program | 450 Broadway St # Mc6343, Redwood City, CA 94063-3132 | 2020-07-31 |
| 1164048658 | Perla Elizabeth Robles | Student in an Organized Health Care Education/Training Program | 1603 Virginia Ave, Redwood City, CA 94061-2636 | 2020-06-19 |
| 1114547494 | Galvin Joseph Loughran | Student in an Organized Health Care Education/Training Program | 430 Broadway St Fl C4, Redwood City, CA 94063-3132 | 2020-04-16 |
| 1306371679 | Caely Alise Hambro | Student in an Organized Health Care Education/Training Program | Stanford Dermatology, 430 Broadway, Redwood City, CA 94063 | 2017-04-25 |
| 1861925869 | Gary Oscar Vargas | Student in an Organized Health Care Education/Training Program | 450 Broadway St # Ms 6342, Redwood City, CA 94063-3132 | 2017-04-06 |
| 1295288264 | Benjamin Dickter | Student in an Organized Health Care Education/Training Program | 1107 2nd Ave, Apt 103, Redwood City, CA 94063 | 2016-07-26 |
| 1740639228 | Mariya Wolff | Student in an Organized Health Care Education/Training Program | 648 Redwood Ave, Redwood City, CA 94061-2228 | 2016-06-06 |
| 1114381373 | Sahitya Denduluri | Student in an Organized Health Care Education/Training Program | 450 Broadway Street Pavilion C, 4th Floor, Redwood City, CA 94063 | 2016-04-13 |
| 1376907741 | Kenneth Tran | Student in an Organized Health Care Education/Training Program | 1660 Gordon St Apt 21, Redwood City, CA 94061-6800 | 2016-04-11 |
| Find all providers in REDWOOD CITY | ||||
| City | REDWOOD CITY |
| Zip Code | 94063 |
Please comment or provide details below to improve the information on DEREK MICHAEL BEAULIEU.
| 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.