MR. STEPHEN KENNETH BONIFACE MSN NP AGPCNP-BC NPI 1790178317

NPI Information

NPI: 1790178317
Provider Name: MR. STEPHEN KENNETH BONIFACE, MSN, NP, AGPCNP-BC
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
393 BLOSSOM HILL RD
SUITE 390B
SAN JOSE, CA
ZIP 95123
Phone: (408) 794-1250
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MR. Stephen Kenneth Boniface, MSN, NP, AGPCNP-BC is an adult health nurse practitioner in San Jose, CA. MR. Stephen Kenneth Boniface, MSN, NP, AGPCNP-BC NPI is 1790178317. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

393 BLOSSOM HILL RD
SUITE 390B
SAN JOSE, CA
ZIP 95123-652
Phone: (408) 794-1250

The NPI 1790178317 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/5/2015 and was last updated on 5/4/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	95002018	CALIFORNIA	No
2	363LA2200X	Nurse Practitioner	Adult Health	95002018	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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