Provider Demographics
NPI:1760935753
Name:BONNES, KEITH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:
Last Name:BONNES
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 TOWN AND COUNTRY DR STE E
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-3995
Mailing Address - Country:US
Mailing Address - Phone:925-263-2342
Mailing Address - Fax:
Practice Address - Street 1:140 TOWN AND COUNTRY DR STE E
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-3995
Practice Address - Country:US
Practice Address - Phone:925-263-2342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY34251103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical