Provider Demographics
NPI:1386847440
Name:BONDARENKO, MARINA (RN)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:BONDARENKO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21322 LEMARSH
Mailing Address - Street 2:APT # 311
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311
Mailing Address - Country:US
Mailing Address - Phone:818-882-3808
Mailing Address - Fax:818-882-3808
Practice Address - Street 1:21323 LEMARSH ST
Practice Address - Street 2:#311
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-6749
Practice Address - Country:US
Practice Address - Phone:818-882-3808
Practice Address - Fax:818-882-3808
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA652896163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management