Tristen R Bogue
Individual provider Active NPI Case Manager/Care Coordinator · Sonora, CA
NPI 1760972723 · NPPES record last updated May 15, 2018
Key facts
- NPI
- 1760972723
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 105 Hospital Rd
Sonora, CA 95370-5227 - Phone
- (209) 533-6245
- NPI assigned
- May 15, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Tuolumne | Past |
Accepting new patients | |
| County of Tuolumne | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
105 Hospital Rd
Sonora, CA 95370-5227
Mailing address
2 S Green St
Sonora, CA 95370-4618
Phone (209) 533-6245
Other providers in Sonora, CA
- Charles Henry Black IV
- Janet L Black
- Jeanina Bloom
- Karen Maureen Blum
- Bob'S Greenley Pharmacy Inc
- David Bohannon
- Maria Claire Boklund
- Renee Michelle Bond
- Bones Physical Therapy
- Kevin Charles Booth
All providers in Sonora, CA · Case Manager/Care Coordinator in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2018. 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.