MEDICARE: KRISTYN BONAYON OTR/L

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
1	225X00000X	Occupational Therapist	13180	CA

General Provider Information

NPI Number	:	1366875296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTYN BONAYON OTR/L

Provider Business Mailing Address
First Line	:	2708 S PARCO AVE
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91761-7019
Country	:	US
Telephone Number	:	310-872-6246
Fax Number	:

Provider Business Practice Location Address
First Line	:	13461 RAMONA AVE
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-5029
Country	:	US
Telephone Number	:	909-628-1201
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2013
Last Update Date	:	04/17/2026

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