Individual provider Active NPI

Andrew Benjamin Bonnett

  • Mental Health Counselor
  • Los Osos, CA
National Provider Identifier
1962640078
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1685 18TH St.
Los Osos, CA 93402
Phone
(805) 781-3535
NPI assigned
Jan 27, 2009
Reactivated
Mar 30, 2012
Last updated
Oct 23, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

1685 18TH St.
Los Osos, CA 93402

Mailing address

1685 18TH St.
Los Osos, CA 93402
Phone (805) 781-3535

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

NPI Registry JSON

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350950400000",
    "number": "1962640078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 18TH ST.",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "93402",
            "telephone_number": "805-781-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 18TH ST.",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "93402",
            "telephone_number": "805-781-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNETT",
        "first_name": "ANDREW",
        "middle_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-27",
        "last_updated": "2012-10-23",
        "deactivation_date": "2010-09-28",
        "reactivation_date": "2012-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Osos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.