Individual
BONNITTA KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3301 E 12TH ST STE 259, OAKLAND, CA 94601-2940
(510) 269-9030
Mailing address
610 E 18TH ST APT H, OAKLAND, CA 94606-2439
(510) 241-7965
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/29/2007
Last updated
10/12/2021
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