BRYAN BOLDUC (NPI# 1396386934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396386934 |
| Entity Type | Individual |
| Full Name | BRYAN BOLDUC |
| Practice Address |
1904 Richland Ave Bldg D Ceres CA 95307-4562 |
| Mailing Address |
1001 Needham St Modesto CA 95354-0730 |
| Practice Telephone | 2095690373 |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2019-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 374700000X | Technician | Nursing Service Related Providers | ||
| N | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
1904 RICHLAND AVE BLDG D |
| City | CERES |
| State | CA |
| Zip Code | 95307-4562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114348075 | Samantha Valladares | Social Worker | 1904 Richland Ave Bldg D, Ceres, CA 95307-4562 | 2013-12-19 |
| 1629676325 | Erica Hide Tinajero | Peer Specialist | 1904 Richland Ave Bldg D, Ceres, CA 95307-4562 | 2020-10-14 |
| 1356948442 | Andrea Lindsey Silva | Peer Specialist | 1904 Richland Ave Bldg D, Ceres, CA 95307-4562 | 2020-10-02 |
| 1386286383 | Christy Cupit | Marriage & Family Therapist | 1904 Richland Ave Bldg D, Ceres, CA 95307-4562 | 2019-10-10 |
| 1295392801 | Nicole Lynette Dove | Peer Specialist | 1904 Richland Ave Bldg D, Ceres, CA 95307-4562 | 2019-05-20 |
| 1376012559 | David Andrew Kirkpatrick | Technician | 1904 Richland Ave Bldg D, Ceres, CA 95307 | 2018-11-17 |
| 1265834790 | Huey Peing Tan | Counselor | 1904 Richland Ave Bldg D, Ceres, CA 95307 | 2014-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144762022 | Roxanne Mata | Technician | 1904 Richland Ave., Ceres, CA 95307 | 2016-11-09 |
| 1023496379 | Steven Leonard II | Technician, Other | 1904 Richalnd Ave, Ceres, CA 95307 | 2015-05-07 |
| 1942619820 | Thevi Phanthalangsy | Pharmacist | 1421 Coffee Road, Modesto, CA 95307 | 2014-08-05 |
| 1588973937 | Gloria June Coats | Nurse Practitioner | 3641 Mitchell Road, Suite H, Ceres, CA 95307 | 2010-10-04 |
| 1992953236 | John H Meekay | Dentist | 1788 Mitchell Road Suite 105, Ceres, CA 95307 | 2008-08-28 |
| 1316073778 | Donna J Payne | Case Manager/Care Coordinator | 1904 Richland Avenue, Ceres, CA 95307 | 2007-02-27 |
| 1104994656 | Katherine Anne Kucera | Dentist | 3507 Morgan Rd, Ceres, CA 95307 | 2006-12-01 |
| 1073615084 | Tracy S Park | Dentist | 2760 3rd Street, Suite A, Ceres, CA 95307 | 2006-09-01 |
| 1902855588 | Kerry B Evnin Md Inc A Professional Medical Corporation | Family Medicine | 3641 Mitchell Rd, H, Ceres, CA 95307 | 2006-05-09 |
| 1235618794 | Jessica Danette Miller | Licensed Vocational Nurse | 1904 Richland Ave Bldg A, Ceres, CA 95307 | 2018-08-07 |
| Find all providers in zip 95307 | ||||
| Taxonomy Code | 374700000X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| (1) A person with specialized training in a narrow field of expertise whose occupation requires training and is skilled in specific technical processes and procedures. (2) An individual having special skill or practical knowledge in an area, such as operation and maintenance of equipment or performance of laboratory procedures involving biochemical analyses. Special technical qualifications are normally required, though an increasing number or technicians also possess university degrees in science, and occasionally doctorate degrees. The distinction between technician and technologist in the health care field is not always clear. |
| Notes: Sources: (1) Rhea, Ott, and Shafritz, The Facts on File Dictionary of Health Care Management, New York: Facts on File Publications, 1988; Dorland’s Illustrated Medical Dictionary, 26th Edition, Philadelphia: W.B. Saunders Company, 1981 and Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1984. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 776. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144762022 | Roxanne Mata | Technician | 1904 Richland Ave., Ceres, CA 95307 | 2016-11-09 |
| 1124654447 | James Verma | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-03-18 |
| 1144856576 | Randy Lee Freitas | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-03-17 |
| 1922639038 | Sarah Marie Norwood | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2020-01-28 |
| 1336791052 | Travis Shawn Whitehead | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-07-12 |
| 1487212288 | Sandra Elaine Ainslie | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-06-05 |
| 1699333153 | Cherish Anne Medeiros | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-05-30 |
| 1508328469 | Heather Gomez | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-04-01 |
| 1710441746 | Janis H Hubbard | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-01-23 |
| 1942773023 | Franklin George | Technician | 1904 Richland Ave, Ceres, CA 95307-4562 | 2019-01-10 |
| Find all providers in CERES | ||||
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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.