Hicks-Bonam, Jazzmin Tonai

Hicks-Bonam, Jazzmin Tonai is an sole proprietor health care provider with primary practice located at 12968 Frederick St Ste D , Moreno Valley CA 92553-5229. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hicks-Bonam, Jazzmin Tonai can be contacted via phone (951) 208-0150.

Contact Information

Primary practice address
12968 Frederick St Ste D Moreno Valley CA 92553-5229
Phone: (951) 208-0150
Fax: (951) 208-0409
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 32243 California

Profile Details

NPI number 1861098725
LBN Legal business name Hicks-Bonam, Jazzmin Tonai
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 7th, 2020
Last updated Sep 2nd, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861098725 NPPES
California Other 32243 BOARD OF PSYCHOLOGY

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