Active NPI
Debra Anne Bonnefin, DC
- Rehabilitation Chiropractor
- Tustin, CA
National Provider Identifier
1902024102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- 13742
- Practice address
- 360 E 1St St # 763
Tustin, CA 92780-3211 - Phone
- (415) 231-4848
- NPI assigned
- Apr 23, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 13742 | CA | Primary |
Addresses
Primary practice location
360 E 1St St # 763
Tustin, CA 92780-3211
Mailing address
360 E 1St St # 763
Tustin, CA 92780-3211
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13742 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392249600000",
"number": "1902024102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 E 1ST ST # 763",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 E 1ST ST # 763",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803211",
"telephone_number": "415-231-4848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNEFIN",
"first_name": "DEBRA",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2014-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CA",
"license": "13742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.