Provider Demographics
NPI:1629398342
Name:BONCHAY, BRIGITTE PAULINE (LCSW)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:PAULINE
Last Name:BONCHAY
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 1:25330 SILVER ASPEN WAY APT 232
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91381-0712
Mailing Address - Country:US
Mailing Address - Phone:661-312-8562
Mailing Address - Fax:661-902-6982
Practice Address - Street 1:25330 SILVER ASPEN WAY APT 232
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91381-0712
Practice Address - Country:US
Practice Address - Phone:661-312-8562
Practice Address - Fax:661-902-6982
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical