Richard Joseph Beaulieu, PNP-BC
Individual provider Active NPI Pediatric Nurse Practitioner · Union City, CA
NPI 1245544360 · NPPES record last updated Aug 27, 2021
Key facts
- NPI
- 1245544360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 10621 (CA)
- Practice address
- 1800 H St RM 80
Union City, CA 94587-3321 - Phone
- (510) 471-5880
- NPI assigned
- Jul 30, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10621 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tiburcio Vasquez Health Center, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 10621 | CA | Yes |
Addresses
Primary practice location
1800 H St RM 80
Union City, CA 94587-3321
Mailing address
22331 Mission Blvd
Hayward, CA 94541-3911
Phone (510) 471-5880
Other practice location 1
22331 Mission Blvd
Hayward, CA 94541-3911
Phone (510) 471-5880
Other providers in Union City, CA
- Richard S Barth
- Vijaya Sharan Basawaprasad
- Francine Bashan
- Michaela Battaglia
- Romeo Serra Bautista D
- Waania Beg
- Darlene Behr
- Lydia Benjamin-Ajani
- Arnold C Berman
- Elliot Gan Hong Bernadel-Huey
All providers in Union City, CA · Pediatric Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.