Provider Demographics
NPI:1639667447
Name:LANDAU WEED, BONNIE LEE (MS, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:LEE
Last Name:LANDAU WEED
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 MAHONEY AVE
Mailing Address - Street 2:
Mailing Address - City:OAK VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:93022-9445
Mailing Address - Country:US
Mailing Address - Phone:805-669-6106
Mailing Address - Fax:
Practice Address - Street 1:196 MAHONEY AVE
Practice Address - Street 2:
Practice Address - City:OAK VIEW
Practice Address - State:CA
Practice Address - Zip Code:93022-9445
Practice Address - Country:US
Practice Address - Phone:805-669-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13456101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional