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Physician Compare National (NPI:1992122865)

HEALTHCARE PROVIDER: MARY JOY BODZIOCH PH.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1992122865
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0446475636
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20140701002209
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name BODZIOCH
Individual professional last name
Provider First Name MARY
Individual professional first name
Provider Middle Name J
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1983
Individual professional's medical school graduation year
Primary Specialty PSYCHOLOGIST, CLINICAL
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 231 OLD BERNAL AVE
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 9
Group Practice or individual's line 2 address
City PLEASANTON
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 945667015
Group Practice or individual's zip code (9 digits when available)
Phone Number 9254005744
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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