Active NPI
Nicole Bonilla
- Behavior Technician
- Culver City, CA
National Provider Identifier
1033841655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 5901 Green Valley Cir Ste 466
Culver City, CA 90230-6970 - Phone
- (951) 455-2447
- NPI assigned
- Jun 30, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
5901 Green Valley Cir Ste 466
Culver City, CA 90230-6970
Mailing address
16500 Ventura Blvd Ste 414
Encino, CA 91436-5050
Other practice location 1
312 W Wilshire Ave Apt A
Fullerton, CA 92832-1770
Phone (951) 455-2447
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1033841655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16500 VENTURA BLVD STE 414",
"city": "ENCINO",
"state": "CA",
"postal_code": "914365050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 GREEN VALLEY CIR STE 466",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902306970",
"telephone_number": "951-455-2447"
}
],
"practiceLocations": [
{
"address_1": "312 W Wilshire Ave Apt A",
"address_purpose": "LOCATION",
"city": "Fullerton",
"state": "CA",
"postal_code": "928321770",
"country_code": "US",
"telephone_number": "951-455-2447",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BONILLA",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-30",
"last_updated": "2022-08-11",
"certification_date": "2022-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.