Eloisa Bonilla, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT124853 Issued in CA

Practice address

2309 Pacific Coast Hwy Ste 202
Hermosa Beach, CA 90254-2753

Phone

(310) 359-0320

NPI assigned

Jul 11, 2018

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238
  Medicare reassignment

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1982180121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1173",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902511173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 PACIFIC COAST HWY STE 202",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542753",
            "telephone_number": "310-359-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "ELOISA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT124853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Pacific Aesthetic Medical Group
• Michele Lorraine Blume, PSY.D.
• Winnifred Katherine Boeckmann, AMFT
• Rachel Sarah Bogner, LCSW
• Sarah Ashley Bolla, BCBA
• Linda Elizabeth Bonilla
• Whitney Boole Williams, LMFT
• Samantha Bordener, DDS
• Cassandra L Bowles, PSYD
• Ashley Lauren Boyer, SLP

• Marriage & Family Therapist in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.