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NPI Code Detail

MEDICARE: MICHELE E BOURBONNAIS LPCC

MEDICARE: MICHELE E BOURBONNAIS LPCC
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
1101YM0800XMental Health Counselor5975CA
2101YP2500XProfessional CounselorLPCC5975CA

General Provider Information

NPI Number : 1699148650
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE E BOURBONNAIS LPCC
Provider Business Mailing Address
First Line : 675 W FOOTHILL BLVD STE 200
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-3475
Country : US
Telephone Number : 925-282-1778
Fax Number :
Provider Business Practice Location Address
First Line : 675 W FOOTHILL BLVD STE 200
Second Line :
City : CLAREMONT
State : CA
Zip : 91711-3475
Country : US
Telephone Number : 925-282-1778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2015
Last Update Date : 04/15/2024

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Directions to “ MICHELE E BOURBONNAIS LPCC” Practice Location

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