Individual
BONNIE JEAN GASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5436 S BROADWAY, LOS ANGELES, CA 90037-4126
(323) 234-6261
Mailing address
240 W 46 ST., LOS ANGELES, CA 90037-4126
(323) 329-2542
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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