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NPI Code Detail

MEDICARE: MS. AMINATA BONGAY

MEDICARE:  MS. AMINATA  BONGAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1093926529
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMINATA BONGAY
Provider Business Mailing Address
First Line : 1650 SPRUCE ST STE 1021650
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-7402
Country : US
Telephone Number : 951-357-6926
Fax Number : 855-568-2494
Provider Business Practice Location Address
First Line : 1650 SPRUCE ST STE 1650
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-7402
Country : US
Telephone Number : 951-357-6926
Fax Number : 855-568-2494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2007
Last Update Date : 12/05/2022

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Directions to “ MS. AMINATA BONGAY ” Practice Location

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