Sara Bockhold, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

60428 Issued in CA

Practice address

4577 La Jolla Village Dr
Suite 1212
La Jolla, CA 92121

Phone

(619) 894-9383

NPI assigned

Dec 30, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1376203497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 GLENWOOD DR",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920576348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4577 LA JOLLA VILLAGE DR",
            "address_2": "SUITE 1212",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "619-894-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCKHOLD",
        "first_name": "SARA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "60428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Block, PH.D.
• Stephanie R Bloom, OTR CHT
• Cinnamon Sue Bloss, PH.D.
• Kenneth John Blunt, M.D.
• Teodora Nikolaeva Bochnakova, M.D.
• Hannah Bodeau
• Jelena Cingel Bodinet, AMFT
• Yvonne Body, PT
• S.Kathryn Boe, MSN
• Gary N Bogart, D.O

• Physician Assistant in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.