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NPI Code Detail

MEDICARE: MARCUZ BOLDEN

MEDICARE: MARCUZ BOLDEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner
2172V00000XCommunity Health Worker
3101Y00000XCounselor

General Provider Information

NPI Number : 1336858521
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCUZ BOLDEN
Provider Business Mailing Address
First Line : 150 GRAND AVE STE 200
Second Line :
City : OAKLAND
State : CA
Zip : 94612-3726
Country : US
Telephone Number : 510-923-1099
Fax Number : 510-923-0894
Provider Business Practice Location Address
First Line : 390 40TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-2633
Country : US
Telephone Number : 510-613-0330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2022
Last Update Date : 06/25/2026

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Directions to “ MARCUZ BOLDEN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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