Provider Information for 1407983554
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Dr. BONNIE BLACKMAN PHD MFT
Other Names:Other Name:Ms. BONITA GERLASex: Female
NPI: 1407983554
Last Updated: 2024-08-20
Certification Date: 2024-08-20
Certification Date: 2024-08-20
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1407983554 | ||||||||
| Enumeration Date | 2007-02-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3142 BALI LN ALAMEDA, CA 94502-6905 United States Phone: 510-381-2791 | Fax: | ||||||||
| Primary Practice Address | 3142 BALI LN ALAMEDA, CA 94502-6905 United States Phone: 510-381-2791 | Fax: | ||||||||
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