Individual
MS. JENNY JOAN BONACCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNS, CPNP
Contact information
Practice address
1600 EUREKA RD, BUILDING C, UROLOGY, ROSEVILLE, CA 95661-3027
(916) 784-4160
Mailing address
8445 GREENTRAILS WAY, ELK GROVE, CA 95624-4501
(916) 688-1414
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
587187
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
587187
CA
364SP0200X
Pediatric Clinical Nurse Specialist
587187
CA
Other
Enumeration date
03/09/2007
Last updated
01/11/2022
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