Individual
DR. BONITA WEAVINGEARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11080 W OLYMPIC BLVD FL 1, LOS ANGELES, CA 90064-1937
(310) 699-6610
Mailing address
11080 W OLYMPIC BLVD FL 1, LOS ANGELES, CA 90064-1937
(310) 699-6610
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY17678
CA
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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