Misty Diane Bonta, LEP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3664 Issued in CA

Practice address

6935 Colorado Ave
La Mesa, CA 91942-1107

Phone

(916) 752-5513

NPI assigned

Oct 8, 2021

Last updated

Oct 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1336801182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6935 COLORADO AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421107",
            "telephone_number": "916-752-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6935 COLORADO AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421107",
            "telephone_number": "916-752-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONTA",
        "first_name": "MISTY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "LEP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "3664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbonta@hightechhigh.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ROI",
            "address_1": "6935 Colorado Ave",
            "city": "LA Mesa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "919421107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Faith Aftreth Bolam, D.D.S.
• Leila Sofia Bolandgray, M.D.
• Talita Cila Bolomey, D.P.T.
• Lidia A. Bonilla
• Stephanie Davis Bonnafoux, M.A.COUNSELING
• Rebecca Sue Boon, LCSW
• Paloma Borbon
• Elise Borja, RN
• Sonya H Borkat, PT
• Brianna Bosket

• Psychologist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.