Provider Demographics
NPI:1942288113
Name:ABEL, BONNIE KROSNER (PHD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:KROSNER
Last Name:ABEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 W COLORADO ST STE 207
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-3046
Mailing Address - Country:US
Mailing Address - Phone:818-241-2441
Mailing Address - Fax:818-241-2442
Practice Address - Street 1:427 W COLORADO ST STE 207
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-3046
Practice Address - Country:US
Practice Address - Phone:818-241-2441
Practice Address - Fax:818-241-2442
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14494103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY144940Medicaid
CACP14494Medicare ID - Type Unspecified
CAS42018Medicare UPIN