Healthcare Provider Details

I. General information

NPI: 1811820921
Provider Name (Legal Business Name): BONAO FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 9TH ST STE 223
REDLANDS CA
92374-4412
US

IV. Provider business mailing address

PO BOX 1173
REDLANDS CA
92373-0381
US

V. Phone/Fax

Practice location:
  • Phone: 909-229-6405
  • Fax:
Mailing address:
  • Phone: 909-229-6405
  • Fax:

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: DR. MARTHA I. DAGGETT
Title or Position: PRESIDENT
Credential: DSW, MS, LMFT
Phone: 909-229-6405