Kelly Adeline Bonham, is a
Student In An Organized Health Care Education/training Program based in Santa Ana, California. Kelly Adeline Bonham is licensed to practice in * (Not Available) (license number ) and her current practice location is
200 W Santa Ana Blvd, Santa Ana, California. She can be reached at her office (for appointments etc.) via phone at
(714) 480-6650.
NPI number for Kelly Adeline Bonham is 1356178875 and her current mailing address is 200 W Santa Ana Blvd, Santa Ana, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1356178875.
Healthcare Provider's Profile
| Full Name | Kelly Adeline Bonham |
|---|
| Gender | Female |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 200 W Santa Ana Blvd, Santa Ana, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1356178875
- Provider Enumeration Date: 09/18/2024
- Last Update Date: 10/21/2024
Medical Identifiers
Medical identifiers for Kelly Adeline Bonham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356178875 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 19323 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Adeline Bonham is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kelly Adeline Bonham,
200 W Santa Ana Blvd,
Santa Ana, CA 92701-4134
Ph: (714) 480-6650 | Kelly Adeline Bonham,
200 W Santa Ana Blvd,
Santa Ana, CA 92701-4134
Ph: (714) 480-6650 |
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