Individual
ANDREA BONNENFANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9980 LIVE OAK BLVD, LIVE OAK, CA 95953-2334
(530) 695-0700
(530) 695-0701
Mailing address
1686 HACIENDA CT, YUBA CITY, CA 95993-7704
(530) 741-6245
(530) 743-5044
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
16633
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16633
LICENSE
CA
Enumeration date
11/16/2006
Last updated
12/02/2011
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