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General NPI Number Information
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NPI Number | 1790261980
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Entity Type | Individual
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Provider Name | JOHN BOSCO SALDANA BUNYI AMFT
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Gender | Male
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 145 W MAIN ST STE 250
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City | TUSTIN
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State | CA
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Zip | 92780-7751
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Country | US
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Telephone | 949-231-7129
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Fax |
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Provider Business Mailing Address
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Address Line | 7651 AMAZON DR APT 2
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-8627
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Country | US
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Telephone | 925-759-6904
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 95340
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License Number State | CA
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