Provider Demographics
NPI:1659420750
Name:CABASINO, BONNIE JOAN (MS SPEECH PATHOLOGIS)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:JOAN
Last Name:CABASINO
Suffix:
Gender:F
Credentials:MS SPEECH PATHOLOGIS
Other - Prefix:MRS
Other - First Name:BONNIE
Other - Middle Name:JOAN BAILEY
Other - Last Name:CABASINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SPEECH PATHOLOGIST M
Mailing Address - Street 1:1425 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5318
Mailing Address - Country:US
Mailing Address - Phone:925-295-6390
Mailing Address - Fax:
Practice Address - Street 1:1425 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5318
Practice Address - Country:US
Practice Address - Phone:925-295-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7783235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist