Healthcare Provider Details

I. General information

NPI: 1124736178
Provider Name (Legal Business Name): ELIZABETH BOLIARD OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH O'NEILL

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 SUNSET BLVD STE 110
ROCKLIN CA
95765-4497
US

IV. Provider business mailing address

2320 SUNSET BLVD STE 110
ROCKLIN CA
95765-4497
US

V. Phone/Fax

Practice location:
  • Phone: 916-624-9396
  • Fax:
Mailing address:
  • Phone: 916-624-9396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35353
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: