Andrea Bonnenfant

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

16633 Issued in CA

Practice address

9980 Live Oak Blvd
Live Oak, CA 95953-2334

Phone

(530) 695-0700

Fax

(530) 695-0701

NPI assigned

Nov 16, 2006

Last updated

Dec 2, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Andrea Bonnefant Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abonnenfant216585@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sutter Valley Medical Foundation

  dba Sutter Gould Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment NPD
• Ronald D Hart, MD

  • Family Medicine Physician
  • Yuba City, CA
  • NPI 1356442032
  Medicare reassignment
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Sutter Valley Medical Foundation

  dba Sutter North Medical Foundation

  • Multi-Specialty Clinic/Center
  • Yuba City, CA
  • NPI 1992939565
  NPD

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1972676922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1686 HACIENDA CT",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959937704",
            "telephone_number": "530-741-6245",
            "fax_number": "530-743-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9980 LIVE OAK BLVD",
            "city": "LIVE OAK",
            "state": "CA",
            "postal_code": "959532334",
            "telephone_number": "530-695-0700",
            "fax_number": "530-695-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNENFANT",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "16633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "16633",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BONNEFANT",
            "credential": "PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lizeth Betancourt, IBCLC
• Andrea R Boatwright
• Lisa M Boyan, PHYSICAL THERAPIST
• Tanya Brown, MD
• Eduardo Bucio
• Buddys Ranch LLC
• Yesenia Carrasco

• Physician Assistant in Live Oak, CA
• Providers in Live Oak, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.