Individual provider Active NPI

Gina Marie Bodnar, M.S.

  • Marriage & Family Therapist
  • Anaheim, CA
National Provider Identifier
1558553669
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1188 N Euclid St
Suite Number #500
Anaheim, CA 92801-1900
Phone
(714) 223-2600
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1188 N Euclid St
Suite Number #500
Anaheim, CA 92801-1900

Mailing address

1188 N Euclid St
Suite Number #500
Anaheim, CA 92801-1900
Phone (714) 223-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240605001280 CA Practitioner - Marriage and Family Therapist 1658813712 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 28, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 28, 2024 Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

1188 N Euclid St
#500
Anaheim, CA 92801
Phone (714) 254-2845

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

393 E Walnut St
Pasadena, CA 91188
Phone (626) 405-7914

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438905600000",
    "number": "1558553669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1188 N EUCLID ST",
            "address_2": "SUITE NUMBER #500",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011900",
            "telephone_number": "714-223-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 N EUCLID ST",
            "address_2": "SUITE NUMBER #500",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011900",
            "telephone_number": "714-223-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODNAR",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2015-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.