Darby Furth Bonomi, PH.D.
Individual provider Active NPI Exercise & Sports Psychologist · Corte Madera, CA
NPI 1043075674 · NPPES record last updated Feb 13, 2024
Key facts
- NPI
- 1043075674
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Exercise & Sports Psychologist 103TE1100X
- License
- PSY12925 (CA)
- Practice address
- 8 Alta Way
Corte Madera, CA 94925-1557 - Phone
- (415) 713-4234
- NPI assigned
- Feb 13, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY12925 | CA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY12925 | CA | |
| Exercise & Sports Psychologist | 103TE1100X | PSY12925 | CA | Yes |
Addresses
Primary practice location
8 Alta Way
Corte Madera, CA 94925-1557
Mailing address
8 Alta Way
Corte Madera, CA 94925-1557
Phone (415) 713-4234
Other providers in Corte Madera, CA
- Emily Jo Bernard
- Anne K Bjork
- Martin Block
- John Edwin Boland IV
- John Edwin Boland III
- Steven S Bordunov
- Edwin B. Bottum-Morgan
- Marion Katherine Brennan
- Brett V. Curtis, M.D. Inc. Apc
- Nadine Renee Brinton
All providers in Corte Madera, CA · Exercise & Sports Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.