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General NPI Number Information
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NPI Number | 1629901178
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Entity Type | Individual
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Provider Name | KIMBERLY A BONN
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Gender | Female
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 150 VALPREDA RD
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City | SAN MARCOS
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State | CA
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Zip | 92069-2973
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Country | US
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Telephone | 760-566-1463
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Fax |
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Provider Business Mailing Address
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Address Line | 989 BEACH CREST CT
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City | CARLSBAD
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State | CA
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Zip | 92011-1103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 200286-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95332003
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License Number State | CA
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