Provider Demographics
NPI:1174045157
Name:BONTON, ASHLEY LYNNETTE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:LYNNETTE
Last Name:BONTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2158 PYRAMID DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94803-3220
Mailing Address - Country:US
Mailing Address - Phone:757-701-0653
Mailing Address - Fax:
Practice Address - Street 1:555 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4414
Practice Address - Country:US
Practice Address - Phone:415-894-0661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILSW-2387104100000X
CA1034881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker