Active NPI
Carl Albert Bonacci, PH.D.
- Psychologist
- Phoenix, AZ
National Provider Identifier
1659488583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3376
- Practice address
- 1349 E Colter St
Phoenix, AZ 85014-3048 - Phone
- (928) 257-4897
- Fax
- (866) 534-1701
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 3376 | AZ | |
| Psychologist | 103T00000X | 3376 | AZ | Primary |
| Adult Development & Aging Psychologist | 103TA0700X | 3376 | AZ |
Addresses
Primary practice location
1349 E Colter St
Phoenix, AZ 85014-3048
Mailing address
1349 E Colter St
Phoenix, AZ 85014-3048
Phone (928) 257-4897
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 564527 | Medicaid | AZ |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona Behavioral Home Health | Past | Accepting new patients | |
| Elba Healthcare, LLC | Clinical Neuropsychologist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Neuropsychologist
- Yuma, AZ
- NPI 1487830758
-
- Cognitive & Behavioral Psychologist
- Phoenix, AZ
- NPI 1376623769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1659488583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1349 E COLTER ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850143048",
"telephone_number": "928-257-4897",
"fax_number": "866-534-1701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1349 E COLTER ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850143048",
"telephone_number": "928-257-4897",
"fax_number": "866-534-1701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONACCI",
"first_name": "CARL",
"middle_name": "ALBERT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "AZ",
"license": "3376",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "3376",
"primary": true
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "AZ",
"license": "3376",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "564527",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.