Individual
SANDRA LYNETTE BOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
275 BECK AVE, FAIRFIELD, CA 94533-6804
(707) 208-9996
(707) 427-2774
Mailing address
275 BECK AVE, FAIRFIELD, CA 94533-6804
(707) 208-9996
(707) 427-2774
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
175T00000X
Peer Specialist
MPSS-4N5QTH
CA
372600000X
Adult Companion
Primary
MPSS-4N5QTH
CA
Other
Enumeration date
06/05/2019
Last updated
01/29/2026
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