Individual
BONITA HOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3460 TORRANCE BLVD STE 100, TORRANCE, CA 90503-5812
(310) 371-8555
Mailing address
1605 BENITO AVE, ALHAMBRA, CA 91803-9101
(650) 248-7786
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225X00000X
Occupational Therapist
Primary
24326
CA
Other
Enumeration date
08/13/2019
Last updated
03/10/2025
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