Active NPI
Camera Bonsack, CST II
- Peer Specialist
- Modesto, CA
National Provider Identifier
1013213180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- MPSS-PSQHDC
- Practice address
- 800 Scenic Dr Ste E
Modesto, CA 95350-6131 - Phone
- (209) 531-8016
- Fax
- (209) 525-4590
- NPI assigned
- Feb 7, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | CA | ||
| Peer Specialist | 175T00000X | MPSS-PSQHDC | CA | Primary |
Addresses
Primary practice location
800 Scenic Dr Ste E
Modesto, CA 95350-6131
Mailing address
522 E Granger Ave
Modesto, CA 95350-4545
Phone (209) 585-4610
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MPSS-PSQHDC | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747353600000",
"number": "1013213180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 E GRANGER AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504545",
"telephone_number": "209-585-4610",
"fax_number": "209-525-4590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 SCENIC DR STE E",
"city": "MODESTO",
"state": "CA",
"postal_code": "953506131",
"telephone_number": "209-531-8016",
"fax_number": "209-525-4590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONSACK",
"first_name": "CAMERA",
"credential": "CST II",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-07",
"last_updated": "2025-05-16",
"certification_date": "2025-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-PSQHDC",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.