MR. STEPHEN KENNETH BONIFACE (NPI# 1790178317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790178317 |
Entity Type | Individual |
Full Name | MR. STEPHEN KENNETH BONIFACE |
Credential | MSN, NP, AGPCNP-BC |
Practice Address |
393 Blossom Hill Rd Suite 390b San Jose CA 95123-1652 |
Practice Telephone | 4087941250 |
Mailing Telephone | 4087941250 |
Enumeration Date | 2015-03-05 |
Last Update Date | 2015-05-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
95002018 | CA | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
95002018 | CA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
393 BLOSSOM HILL RD SUITE 390B |
City | SAN JOSE |
State | CA |
Zip Code | 95123-1652 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154392009 | Satellite Healthcare Inc | Clinic/Center | 393 Blossom Hill Rd, Ste 110, San Jose, CA 95123-1652 | 2006-01-30 |
1770951915 | Tri-county Vascular Care, LLC | Clinic/Center | 393 Blossom Hill Rd, San Jose, CA 95123-1652 | 2015-09-03 |
1730525411 | James L Andrews M D A Professional Corporation | Clinic/Center | 393 Blossom Hill Rd, Suite 301, San Jose, CA 95123-1652 | 2013-05-21 |
1013352475 | Leah R Johnson | Pharmacist | 393 Blossom Hill Rd, San Jose, CA 95123-1652 | 2013-04-30 |
1790036101 | Spectrum Eye Physicians, A Medical Corporation | Ophthalmology | 393 Blossom Hill Rd, Suite 265, San Jose, CA 95123-1652 | 2012-09-25 |
1225339211 | C. Desmond Gunatilaka, M.d., Inc. | Clinic/Center | 393 Blossom Hill Rd, Suite 260 B, San Jose, CA 95123-1652 | 2010-11-08 |
1225366990 | Penelope Wells Schenkkan | Behavioral Analyst | 393 Blossom Hill Rd, San Jose, CA 95123-1652 | 2009-11-18 |
1841523230 | Tuan Thanh Pham | Student in an Organized Health Care Education/Training Program | 393 Blossom Hill Rd, Suite 201, San Jose, CA 95123-1652 | 2009-09-16 |
1992956650 | Mike M Chen | Dentist | 393 Blossom Hill Rd, Ste 150, San Jose, CA 95123-1652 | 2008-09-30 |
1437326378 | Terrence Raymond Dwyre | Family Medicine | 393 Blossom Hill Rd, Suite 210, San Jose, CA 95123-1652 | 2008-05-09 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700441045 | Calvin Patrick Nell | Chiropractor | 5570 Sanchez Drive, Ste 100, San Jose, CA 95123 | 2019-05-02 |
1629557152 | Jia Tian | Dentist | 393 Blossom Hill Rd Ste 150, San Jose, CA 95123 | 2018-08-06 |
1003306176 | Western Dental Services, Inc. | Dentist | 451 Blossom Hill Rd Suite 20, San Jose, CA 95123 | 2018-05-15 |
1871004945 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5411 Thornwood Dr, San Jose, CA 95123 | 2017-10-17 |
1437672953 | Mie Mie Chiu | Dietitian, Registered | 276 Palm Valley Blvd #205, San Jose, CA 95123 | 2017-07-18 |
1902335300 | Alfredo Fernandez | Counselor | 5898 Paddon Circle, San Jose, CA 95123 | 2017-06-08 |
1780115444 | Christopher Vi Tran | Case Manager/Care Coordinator | 5579 Lean Avenue, San Jose, CA 95123 | 2017-03-24 |
1205370004 | Linxi Wu | Acupuncturist | 6064 Cahalan Ave, San Jose, CA 95123 | 2016-12-13 |
1013307651 | Kevin Dizon | Dental Hygienist | 6071 Sunstone Drive, San Jose, CA 95123 | 2015-02-04 |
1285031294 | Katie Tran | Dental Assistant | 524 Glenburry Way, San Jose, CA 95123 | 2014-11-20 |
Find all providers in zip 95123 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881050425 | Shairstin Fierro | Nurse Practitioner | 5012 Jarvis Ave, San Jose, CA 95118-2428 | 2016-01-12 |
1710259361 | Erin Kathleen Alicia O'hair | Nurse Practitioner | 255 N White Rd Ste 200b, San Jose, CA 95127 | 2012-01-29 |
1275927204 | Mary Tang Chiang | Nurse Practitioner | 299 Stockton Ave, San Jose, CA 95126 | 2015-03-27 |
1144610122 | Oi Shan Wong | Nurse Practitioner | 255 N White Rd Ste 200b, San Jose, CA 95127-1966 | 2015-01-29 |
1962691725 | Martha Payne | Nurse Practitioner | 55 E Julian St, San Jose, CA 95112-4007 | 2007-10-17 |
1295952711 | Nancy Marie Nuzzolillo | Nurse Practitioner | 1 Washington Sq, San Jose, CA 95192-0037 | 2007-04-18 |
1801915962 | Patricia Ann Latour | Nurse Practitioner | 1 Washington Sq, San Jose, CA 95192-0037 | 2007-03-28 |
1669585501 | Joan Leslie Moschella | Nurse Practitioner | 1691 The Alameda, San Jose, CA 95126-2203 | 2006-08-16 |
1679686554 | Lauren Tang Lym | Nurse Practitioner | 1691 The Alameda, San Jose, CA 95126-2203 | 2006-08-16 |
1619998226 | Anne S Bradford | Nurse Practitioner | 80 Great Oaks Blvd, San Jose, CA 95119-1310 | 2006-07-21 |
Find all providers in SAN JOSE |
Please comment or provide details below to improve the information on MR. STEPHEN KENNETH BONIFACE.
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.