Samantha J. Bedolla
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Pocatello, ID
NPI 1336068618 · NPPES record last updated Jul 16, 2026
Key facts
- NPI
- 1336068618
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 8081510 (ID)
- Practice address
- 1246 Yellowstone Ave Ste C5
Pocatello, ID 83201-4373 - Phone
- (208) 233-0150
- NPI assigned
- Jul 13, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 8081510 | ID | Yes |
Addresses
Primary practice location
1246 Yellowstone Ave Ste C5
Pocatello, ID 83201-4373
Mailing address
566 Randolph Ave
Pocatello, ID 83201-3933
Phone (208) 546-8213
Other providers in Pocatello, ID
- Angela M. Beck
- Tracy Becker
- Jennifer Beckstead
- Robert Mitchell Beckstead
- Susan Beckstead
- Brittany Morgan Beers
- Behavioral Enhancement Services & Treatment LLC
- Behavioral Enhancement Services & Treatment LLC
- Behavioral Enhancement Services & Treatment LLC
- Behavioral Enhancement Services & Treatment LLC
All providers in Pocatello, ID · Student in an Organized Health Care Education/Training Program in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.