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NPI Code Detail

MEDICARE: DR. JOAN W. BONNAR PH.D.

MEDICARE:  DR. JOAN W. BONNAR  PH.D.
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
1103TC0700XClinical PsychologistPSY8741CA

General Provider Information

NPI Number : 1912119058
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOAN W. BONNAR PH.D.
Provider Business Mailing Address
First Line : 1717 UNION ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94123-4406
Country : US
Telephone Number : 415-931-6624
Fax Number :
Provider Business Practice Location Address
First Line : 1717 UNION ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94123-4406
Country : US
Telephone Number : 415-931-6624
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JOAN W. BONNAR PH.D.” Practice Location

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