Healthcare Provider Details

I. General information

NPI: 1871417105
Provider Name (Legal Business Name): BONNIE CHIU AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 BIRCH ST STE 1400
NEWPORT BEACH CA
92660-2150
US

IV. Provider business mailing address

PO BOX 1018
NEWPORT BEACH CA
92659-0018
US

V. Phone/Fax

Practice location:
  • Phone: 949-945-6407
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT156071
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: