Provider Demographics
NPI:1366502205
Name:RIEHL, BONITA FAYE (MFT)
Entity Type:Individual
Prefix:
First Name:BONITA
Middle Name:FAYE
Last Name:RIEHL
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:BONITA
Other - Middle Name:FAYE
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:61 BUTTE VISTA ROAD
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966
Mailing Address - Country:US
Mailing Address - Phone:530-871-1019
Mailing Address - Fax:530-871-1019
Practice Address - Street 1:995 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GRIDLEY
Practice Address - State:CA
Practice Address - Zip Code:95948-2128
Practice Address - Country:US
Practice Address - Phone:530-846-7305
Practice Address - Fax:530-846-6216
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41637106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist