Richard Charles Bonneau

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

C055990518 Issued in CA

Practice address

1290 Tavern Rd
Mammoth Lakes, CA 93546-6601

Phone

(760) 924-1740

Fax

(760) 924-1741

NPI assigned

Jan 6, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Mono

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mammoth Lakes, CA
  • NPI 1538266911
  NPD
• Mono County Behavioral Health

  • Community/Behavioral Health Agency
  • Mammoth Lakes, CA
  • NPI 1861050643
  NPD

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1366712424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO.BOX 2619",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935462619",
            "telephone_number": "760-924-1740",
            "fax_number": "760-924-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 TAVERN RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935466601",
            "telephone_number": "760-924-1740",
            "fax_number": "760-924-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNEAU",
        "first_name": "RICHARD",
        "middle_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-06",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RASI RI-1007151243",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C055990518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Bassler, M.D.
• Scott Thomas Beale
• Jason S Bishop, DDS
• Mary Bathen Bissell, M.D.
• Shanna Lynn Bissonette, D.C.
• Karen Bottom, CNM
• Eric Bourne, M.D.
• Jonathan Bourne, M.D.
• Lucienne Simone Bouvier, MD
• Sandra Bowman, CNOR, RNFA

• Addiction (Substance Use Disorder) Counselor in Mammoth Lakes, CA
• Providers in Mammoth Lakes, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.

Verify at the official NPI Registry.