Individual
CARLOS EDUARDO BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COUNSELOR-MENTAL HEA
Contact information
Practice address
3625 14TH ST, RIVERSIDE, CA 92501-3815
(951) 570-2775
Mailing address
3499 10TH ST, RIVERSIDE, CA 92501-3617
(951) 570-2775
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
CA
Other
Enumeration date
08/17/2021
Last updated
10/06/2025
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