Active NPI
Bonni Rae Funk, MA, LMHC, LPCC
- Professional Counselor
- Truckee, CA
National Provider Identifier
1730415605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1742
- Practice address
- 10775 Pioneer TRL Ste 215
Truckee, CA 96161-0234 - Phone
- (415) 424-4266
- Fax
- (415) 520-6633
- NPI assigned
- Oct 27, 2009
- Last updated
- Oct 31, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH10028 | FL | |
| Professional Counselor | 101YP2500X | 1742 | CA | Primary |
Addresses
Primary practice location
10775 Pioneer TRL Ste 215
Truckee, CA 96161-0234
Mailing address
8300 Esters Blvd Ste 900
Irving, TX 75063-2233
Phone (415) 424-4266
Other practice location 1
475 Biltmore Way Ste 109
Coral Gables, FL 33134-5724
Phone (415) 424-4266
Other practice location 2
4107 McLaughlin Ave
Los Angeles, CA 90066-5449
Phone (323) 909-2831
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH10028 | FL | MD | Mental Health Counselor |
| 1742 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1730415605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8300 ESTERS BLVD STE 900",
"city": "IRVING",
"state": "TX",
"postal_code": "750632233",
"telephone_number": "415-424-4266",
"fax_number": "415-520-6633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10775 PIONEER TRL STE 215",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961610234",
"telephone_number": "415-424-4266",
"fax_number": "415-520-6633"
}
],
"practiceLocations": [
{
"address_1": "475 Biltmore Way Ste 109",
"address_purpose": "LOCATION",
"city": "Coral Gables",
"state": "FL",
"postal_code": "331345724",
"country_code": "US",
"telephone_number": "415-424-4266",
"fax_number": "415-520-6633",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4107 McLaughlin Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900665449",
"country_code": "US",
"telephone_number": "323-909-2831",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FUNK",
"first_name": "BONNI",
"middle_name": "RAE",
"credential": "MA, LMHC, LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-27",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH10028",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "1742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Truckee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.