Individual
DR. CARL ALBERT BONACCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1349 E COLTER ST, PHOENIX, AZ 85014-3048
(928) 257-4897
(866) 534-1701
Mailing address
1349 E COLTER ST, PHOENIX, AZ 85014-3048
(928) 257-4897
(866) 534-1701
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
3376
AZ
103T00000X
Psychologist
Primary
3376
AZ
103TA0700X
Adult Development & Aging Psychologist
3376
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
564527
—
AZ
Enumeration date
08/24/2006
Last updated
09/11/2025
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