Bonilla, Stephanie
Bonilla, Stephanie is an sole proprietor health care provider with primary practice located at 1318 N Avalon Blvd , Wilmington CA 90744-2639. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Bonilla, Stephanie can be contacted via phone (310) 549-2710.Contact Information
Primary practice address
1318 N Avalon Blvd
Wilmington CA 90744-2639
Phone: (310) 549-2710
Fax: (310) 549-2715
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | ||
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1316477250 |
|---|---|
| LBN Legal business name | Bonilla, Stephanie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 13th, 2017 |
| Last updated | Jun 13th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316477250 | NPPES |
| California | MEDICAID | 6197-R |
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