Individual
JESSICA BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 DENNERY RD UNIT 531774, SAN DIEGO, CA 92153-2971
(619) 636-7322
Mailing address
PO BOX 531774, SAN DIEGO, CA 92153-1774
(619) 636-7322
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/03/2022
Last updated
08/29/2024
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