Provider Demographics
NPI:1033725825
Name:A MINDFUL PATH TO MENTAL HEALTH INC
Entity Type:Organization
Organization Name:A MINDFUL PATH TO MENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONILLA JACOME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-536-6030
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-1267
Mailing Address - Country:US
Mailing Address - Phone:916-536-6030
Mailing Address - Fax:916-244-3865
Practice Address - Street 1:10419 OLD PLACERVILLE RD STE 252
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2527
Practice Address - Country:US
Practice Address - Phone:916-536-6030
Practice Address - Fax:916-244-3865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty