Rebecca Rose Bonneville, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95010667 Issued in CA

Practice address

22704 Ventura Blvd Unit 115
Woodland Hills, CA 91364-1333

Phone

(323) 900-5091

Fax

(323) 538-6512

NPI assigned

Sep 16, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1821424375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22704 VENTURA BLVD UNIT 115",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641333",
            "telephone_number": "323-900-5091",
            "fax_number": "323-538-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22704 VENTURA BLVD UNIT 115",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641333",
            "telephone_number": "323-900-5091",
            "fax_number": "323-538-6512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 40th St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946092633",
            "country_code": "US",
            "telephone_number": "510-653-5040",
            "fax_number": "510-653-6475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1921 Ransom Pl",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "37217",
            "country_code": "US",
            "telephone_number": "615-279-6700",
            "fax_number": "510-653-6475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6310 San Vicente Blvd Ste 360",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900485448",
            "country_code": "US",
            "telephone_number": "323-870-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONNEVILLE",
        "first_name": "REBECCA",
        "middle_name": "ROSE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95010667",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "22278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Rhodes Bona, PSY.D
• Alexander Bondarenko, DPT
• Destiny Karen Bonilla
• Kashua Bonilla
• Neha Sharma Bonilla
• Kacy Michelle Boray
• Joyce Ann Borges Maisonet
• Boris Vaisman Medical Coporation
• Alicia Borrero Cruz
• Joseph Salvatore Bosco

• Psychiatric/Mental Health Nurse Practitioner in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.