| Bonnie Deroo Marriage And Family Therapy Corporation | |
|
345 Santa Fe Dr Encinitas CA 92024-5132 | |
| (619) 083-0911 | |
| Not Available |
| Full Name | Bonnie Deroo Marriage And Family Therapy Corporation |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 345 Santa Fe Dr, Encinitas, California |
| Authorized Official Name and Position | Bonnie Joanne Deroo (PRESIDENT AND CEO) |
| Authorized Official Contact | 6194830911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonnie Deroo Marriage And Family Therapy Corporation 9051 Mira Mesa Blvd Ste 910825 San Diego CA 92126-2758 Ph: (619) 483-8238 | Bonnie Deroo Marriage And Family Therapy Corporation 345 Santa Fe Dr Encinitas CA 92024-5132 Ph: (619) 083-0911 |
| NPI Number | 1841064722 |
|---|---|
| Provider Enumeration Date | 11/10/2023 |
| Last Update Date | 11/10/2023 |
| Certification Date | 11/10/2023 |
| Medicare PECOS PAC ID | 4385094481 |
|---|---|
| Medicare Enrollment ID | O20240102003648 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841064722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Bonnie Deroo |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1598433369 PECOS PAC ID: 5294185393 Enrollment ID: I20240104002427 |
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