Provider Demographics
NPI:1457683054
Name:HEMBD, BONITA J (MS)
Entity Type:Individual
Prefix:MRS
First Name:BONITA
Middle Name:J
Last Name:HEMBD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:BONNIE
Other - Middle Name:J
Other - Last Name:HEMBD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:1235 W AVENUE H1
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-1484
Mailing Address - Country:US
Mailing Address - Phone:661-949-1690
Mailing Address - Fax:
Practice Address - Street 1:6400 LAUREL CANYON BLVD STE 600
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1568
Practice Address - Country:US
Practice Address - Phone:800-322-8860
Practice Address - Fax:818-763-3890
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP13064235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist