Healthcare Provider Details

I. General information

NPI: 1427947282
Provider Name (Legal Business Name): SONNET L BONCK RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SONNET CHAKMAKIAN RD

II. Dates (important events)

Enumeration Date: 06/28/2025
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9288 S BOISE CIR
SANDY UT
84070-2900
US

IV. Provider business mailing address

425 CALIFORNIA ST STE 1400
SAN FRANCISCO CA
94104-2116
US

V. Phone/Fax

Practice location:
  • Phone: 307-760-7630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: