Individual
JAZMIN BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9808 VENICE BLVD STE 505, CULVER CITY, CA 90232-6818
(310) 945-3350
(310) 945-3356
Mailing address
9808 VENICE BLVD STE 505, CULVER CITY, CA 90232-6818
(310) 945-3350
(310) 945-3356
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
04/10/2018
Last updated
09/08/2023
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