Provider Demographics
NPI:1790261980
Name:BUNYI, JOHN BOSCO SALDANA (AMFT)
Entity Type:Individual
Prefix:
First Name:JOHN BOSCO
Middle Name:SALDANA
Last Name:BUNYI
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7651 AMAZON DR APT 2
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-8627
Mailing Address - Country:US
Mailing Address - Phone:925-759-6904
Mailing Address - Fax:
Practice Address - Street 1:145 W MAIN ST STE 250
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-7751
Practice Address - Country:US
Practice Address - Phone:949-231-7129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95340106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist