Provider Demographics
NPI:1659905933
Name:BARTOLOME, KRIS ERYK
Entity Type:Individual
Prefix:MR
First Name:KRIS
Middle Name:ERYK
Last Name:BARTOLOME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HEATHCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-2034
Mailing Address - Country:US
Mailing Address - Phone:650-270-1149
Mailing Address - Fax:
Practice Address - Street 1:420 CASSIA ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2011
Practice Address - Country:US
Practice Address - Phone:650-703-3462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator