Active NPI
Bonita Jean Debban, PH.D
- Psychologist
- Oconomowoc, WI
National Provider Identifier
1144274689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2324-057
- Practice address
- 970 S Silver Lake St
Oconomowoc, WI 53066-3802 - Phone
- (262) 567-7900
- Fax
- (262) 567-7908
- NPI assigned
- May 20, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2324-057 | WI | Primary |
Addresses
Primary practice location
970 S Silver Lake St
Oconomowoc, WI 53066-3802
Mailing address
970 S Silver Lake St
Oconomowoc, WI 53066-3802
Phone (262) 567-7900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43550000 | Medicaid | WI | |
| 412024650011 | Other | WI | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2324-057 | WI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1144274689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "970 S SILVER LAKE ST",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530663802",
"telephone_number": "262-567-7900",
"fax_number": "262-567-7908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "970 S SILVER LAKE ST",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530663802",
"telephone_number": "262-567-7900",
"fax_number": "262-567-7908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBBAN",
"first_name": "BONITA",
"middle_name": "JEAN",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-20",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "2324-057",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43550000",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "412024650011",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oconomowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.