Individual
MR. STEPHEN KENNETH BONIFACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, NP, AGPCNP-BC
Contact information
Practice address
393 BLOSSOM HILL RD, SUITE 390B, SAN JOSE, CA 95123-1652
(408) 794-1250
Mailing address
393 BLOSSOM HILL RD, SUITE 390B, SAN JOSE, CA 95123-1652
(408) 794-1250
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95002018
CA
363LG0600X
Gerontology Nurse Practitioner
95002018
CA
Other
Enumeration date
03/05/2015
Last updated
05/04/2015
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