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DR. BRUCE BONGAR PH.D.
Clinical >> Psychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1679794093
Individual Registrant:DR. BRUCE BONGAR PH.D.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
1001 BRIDGEWAY #311 SAUSALITO, CA 94965-2104 US
Tel: 415-215-3797 Fax: --
Tel: 415-215-3797 Fax: --
Contact information for business:
1001 BRIDGEWAY #311 SAUSALITO, CA 94965-2104 US
Tel: 415-215-3797 Fax: --
Tel: 415-215-3797 Fax: --
Registration Information:
NPI: 1679794093
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103TC0700X | Behavioral Health & Social Service Providers Psychologist Clinical | CA | PSY5669 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
