Healthcare Provider Details

I. General information

NPI: 1396406229
Provider Name (Legal Business Name): JULES BOGDANSKI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 GRAND AVE STE 301C
OAKLAND CA
94610-4588
US

IV. Provider business mailing address

230 GRAND AVE STE 301C
OAKLAND CA
94610-4588
US

V. Phone/Fax

Practice location:
  • Phone: 510-289-0858
  • Fax:
Mailing address:
  • Phone: 510-289-0858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MISS JULES BOGDANSKI
Title or Position: ACUPUNCTURIST
Credential: L.AC.
Phone: 510-387-0852