Individual
CAMERA BONSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST II
Contact information
Practice address
800 SCENIC DR STE E, MODESTO, CA 95350-6131
(209) 531-8016
(209) 525-4590
Mailing address
522 E GRANGER AVE, MODESTO, CA 95350-4545
(209) 585-4610
(209) 525-4590
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
CA
175T00000X
Peer Specialist
Primary
MPSS-PSQHDC
CA
Other
Enumeration date
02/07/2011
Last updated
05/16/2025
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