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General NPI Number Information
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NPI Number | 1821886755
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Entity Type | Individual
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Provider Name | HAZEL BONILLA
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Gender | Female
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 921 W AVENUE J STE C
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City | LANCASTER
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State | CA
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Zip | 93534-3443
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Country | US
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Telephone | 661-687-9008
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Fax |
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Provider Business Mailing Address
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Address Line | 921 W AVENUE J STE C
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City | LANCASTER
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State | CA
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Zip | 93534-3443
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Country | US
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Telephone | 661-949-0131
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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