Provider Demographics
NPI:1285453753
Name:MACBRIDE, BONNIE (MFT)
Entity type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:
Last Name:MACBRIDE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 ARLINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:94707
Mailing Address - Country:US
Mailing Address - Phone:510-610-9807
Mailing Address - Fax:
Practice Address - Street 1:183 ARLINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:CA
Practice Address - Zip Code:94707
Practice Address - Country:US
Practice Address - Phone:510-610-9807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38317101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health