Individual
JUSTINE BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 S PACIFIC AVE, SAN PEDRO, CA 90731-2656
(310) 519-8723
Mailing address
936 S CENTRE ST, SAN PEDRO, CA 90731-3737
(213) 751-3036
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-ARUTLH
CA
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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