Basic Information
| Provider Information | |||||||||
| NPI: | 1124639943 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIELEFELD | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | FRANCIS | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 ROWLAND WAY | ||||||||
| Address2: | STE 200 | ||||||||
| City: | NOVATO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949455054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159258950 | ||||||||
| FaxNumber: | 4158972446 | ||||||||
| Practice Location | |||||||||
| Address1: | MARINHEALTH | ||||||||
| Address2: | 75 ROWLAND WAY, #230 | ||||||||
| City: | NOVATO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4158975171 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2020 | ||||||||
| LastUpdateDate: | 09/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | NONE | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.