Hicks-Bonam, Jazzmin Tonai
Hicks-Bonam, Jazzmin Tonai is an sole proprietor health care provider with primary practice located at 12968 Frederick St Ste D , Moreno Valley CA 92553-5229. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hicks-Bonam, Jazzmin Tonai can be contacted via phone (951) 208-0150.Contact Information
Primary practice address
12968 Frederick St Ste D
Moreno Valley CA 92553-5229
Phone: (951) 208-0150
Fax: (951) 208-0409
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 32243 | California |
Profile Details
| NPI number | 1861098725 |
|---|---|
| LBN Legal business name | Hicks-Bonam, Jazzmin Tonai |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 7th, 2020 |
| Last updated | Sep 2nd, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861098725 | NPPES |
| California | Other | 32243 | BOARD OF PSYCHOLOGY |
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