Provider Demographics
NPI:1457775462
Name:CARDELL, BONNIE (LMFT)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:CARDELL
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 FELL ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5147
Mailing Address - Country:US
Mailing Address - Phone:415-484-9894
Mailing Address - Fax:
Practice Address - Street 1:295 FELL ST STE A
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5147
Practice Address - Country:US
Practice Address - Phone:415-484-9894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT102066106H00000X
CA76459106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist