Healthcare Provider Details

I. General information

NPI: 1558385682
Provider Name (Legal Business Name): BONNIE HOOES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BONNIE CHACON

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2183 FAIRVIEW RD STE 100
COSTA MESA CA
92627-5671
US

IV. Provider business mailing address

14271 JEFFREY RD PMB #43
IRVINE CA
92620-3405
US

V. Phone/Fax

Practice location:
  • Phone: 949-515-5440
  • Fax: 949-515-5444
Mailing address:
  • Phone: 949-515-5440
  • Fax: 949-515-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: