Provider Demographics
NPI:1043542152
Name:BONILLA, APRIL DAWN
Entity type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:DAWN
Last Name:BONILLA
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 1:932 N MCKEEVER AVE
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-2333
Mailing Address - Country:US
Mailing Address - Phone:626-551-1492
Mailing Address - Fax:
Practice Address - Street 1:1890 N GAREY AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2923
Practice Address - Country:US
Practice Address - Phone:909-629-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAICAN878OtherLA COUNTY DMH