Healthcare Provider Details

I. General information

NPI: 1659218675
Provider Name (Legal Business Name): BONNEJO ZENI MS PPSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BONNEJO BEAGLE MS PPSC

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31642 EL CAMINO REAL
SAN JUAN CAPISTRANO CA
92675-2616
US

IV. Provider business mailing address

33111 REGATTA CT
SAN JUAN CAPISTRANO CA
92675-4637
US

V. Phone/Fax

Practice location:
  • Phone: 949-493-4533
  • Fax:
Mailing address:
  • Phone: 619-717-0747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number230301156
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: