Provider Demographics
NPI:1881845550
Name:MCDONALD, BONNIE E
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:E
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777A CAPITOLA RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-3024
Mailing Address - Country:US
Mailing Address - Phone:831-462-4122
Mailing Address - Fax:831-476-4396
Practice Address - Street 1:1777A CAPITOLA RD
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-3024
Practice Address - Country:US
Practice Address - Phone:831-462-4122
Practice Address - Fax:831-476-4396
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator