Individual provider · NPI-1

Jennifer Connolly Boldrick, MD

Dermatology · Stanford, CA

NPI number1396966149
StatusActive
Last updated in NPPESApr 16, 2024

Details

NPI
1396966149
Entity type
Individual (NPI-1)
Name
Jennifer Connolly Boldrick
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
May 1, 2007
Certification date
Apr 16, 2024
Last updated
Apr 16, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X DermatologyA88543CAYes

Practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Phone 650-723-4000

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408

Phone 650-596-4160

Other practice locations

301 Industrial Rd
San Carlos, CA 94070-2603

Phone 650-596-4160

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