Provider Demographics
NPI:1871251546
Name:SALAND, BONNIE J (PHD-CA LICENSED MARR)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:J
Last Name:SALAND
Suffix:
Gender:F
Credentials:PHD-CA LICENSED MARR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 POPPY PEAK DRIVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2708
Mailing Address - Country:US
Mailing Address - Phone:818-438-2184
Mailing Address - Fax:
Practice Address - Street 1:1570 POPPY PEAK DRIVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2708
Practice Address - Country:US
Practice Address - Phone:818-438-2184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT32902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist