Provider Demographics
NPI:1285839753
Name:BONARDI, DEBBIE JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:JEAN
Last Name:BONARDI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2333 SAN RAMON VALLEY BLVD
Mailing Address - Street 2:#125
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583
Mailing Address - Country:US
Mailing Address - Phone:925-743-1370
Mailing Address - Fax:925-743-1937
Practice Address - Street 1:2333 SAN RAMON VALLEY BLVD
Practice Address - Street 2:#125
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583
Practice Address - Country:US
Practice Address - Phone:925-743-1370
Practice Address - Fax:925-743-1937
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19384103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical