Basic Information
| Provider Information | |||||||||
| NPI: | 1699098327 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BONILLA | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | DEL REFUGIO | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 314 NORTH MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | PORTERVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932573730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597917000 | ||||||||
| FaxNumber: | 5597821418 | ||||||||
| Practice Location | |||||||||
| Address1: | 1107 WEST POPLAR AVE | ||||||||
| Address2: | |||||||||
| City: | PORTERVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932575839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597817242 | ||||||||
| FaxNumber: | 5597933542 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2010 | ||||||||
| LastUpdateDate: | 05/10/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | NP19212 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.