CARLOS EDUARDO BONILLA (NPI# 1174032122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174032122 |
Entity Type | Individual |
Full Name | CARLOS EDUARDO BONILLA |
Other Name | CARLOS EDUARDO BONILLA |
Credential | APRN |
Practice Address |
1443 West 800 North, Suite #302 Orem UT 84057-3658 |
Mailing Address |
3527 Newland Loop Lehi UT 84043-4617 |
Practice Telephone | 8012350953 |
Mailing Telephone | 8015929350 |
Enumeration Date | 2017-09-21 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5250948-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
George E. Wahlen Va Salt Lake City Health Care System, 500 Foothill Blvd. (00qc), Salt Lake City, UT 84138 | 8015821565 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174900393 | Carlos Alejandro Bonilla Sr. | Social Worker | Carr 171 Km 3.9, Bo Rincon, Cidra, PR 00739 | 2015-04-27 |
1205076338 | Carlos E Bonilla | Dentist | 2370 Maritime Dr, Elk Grove, CA 95758-3639 | 2009-03-02 |
1093127375 | Carlos Bonilla | Behavioral Analyst | 8282 28th Ct Ne, Suite A, Lacey, WA 98516-7162 | 2014-05-21 |
1821361270 | Carlos Eduardo Bonilla | Counselor | 1855 Olympic Blvd, Suite 225, Walnut Creek, CA 94596-5089 | 2012-02-15 |
1245508068 | Carlos Daniel Bonilla | Chiropractor | 3900 Nw 79th Ave, Suite 201, Doral, FL 33166-6556 | 2011-12-07 |
1477872802 | Carlos Bonilla | Case Manager/Care Coordinator | 673 San Jose Ave, San Francisco, CA 94110-4914 | 2010-05-25 |
Street Address |
1443 WEST 800 NORTH, SUITE #302 |
City | OREM |
State | UT |
Zip Code | 84057-3658 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013529932 | Jessica Chang | Social Worker | 870 W, Center, UT 84057 | 2020-08-21 |
1750991402 | Dr. Alexander B. Larsen Dds | Dentist | 385 W. Center Street, Orem, UT 84057 | 2020-08-07 |
1750911996 | Joanna Ramirez | Behavioral Analyst | 1443 West 800 North #103, Orem, UT 84057 | 2020-01-15 |
1790321842 | Nicole Rose Mcdougal | Speech-Language Pathologist | 527 400 N, Ste 2, Orem, UT 84057 | 2019-11-25 |
1871151837 | Robert B Fujiki | Speech-Language Pathologist | 1935 N90 W, Orem, UT 84057 | 2019-06-04 |
1669965562 | Brian Quigley Inc. | Hearing Instrument Specialist | 895 West Center Street, Orem, UT 84057 | 2018-06-14 |
1568960250 | Catherine Collins | Nurse Practitioner | 700 W. 800 N., Suite 220, Orem, UT 84057 | 2018-01-27 |
1821596073 | Venice Lucia Wilkes | Physician Assistant | 700 W 800 N # 220, Orem, UT 84057 | 2018-01-23 |
1851811160 | Jessie Carlson | Behavior Technician | 475 West 260 North, Orem, UT 84057 | 2017-06-27 |
1588013890 | Li Ping Su | Marriage & Family Therapist | 1027 W 1033 N, S108, Orem, UT 84057 | 2016-06-07 |
Find all providers in zip 84057 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518575695 | Rachael A Bennett | Nurse Practitioner | 735 N 550 W, Orem, UT 84057-3793 | 2020-07-15 |
1205476272 | Rebecca Rae Oakley | Nurse Practitioner | 417 S Palisades Dr, Orem, UT 84097-6694 | 2020-01-08 |
1063973832 | Holly Lee Carter | Nurse Practitioner | 1260 S 1600 W, Orem, UT 84058-4931 | 2019-03-26 |
1902371826 | Jennifer Morgan Ellefsen | Nurse Practitioner | 800 W University Pkwy # Ms 200, Orem, UT 84058 | 2018-10-07 |
1700399573 | Heidi Jensen | Nurse Practitioner | 495 S 1100 W, Orem, UT 84058-5831 | 2017-11-14 |
1649722893 | Sarah Stocksdale | Nurse Practitioner | 378 S 1000 E, Orem, UT 84097-5711 | 2016-11-03 |
1689123481 | Sophia Mae Larimer | Nurse Practitioner | 1043 N 920 W Apt 611, Orem, UT 84057-4102 | 2016-09-22 |
1962957407 | Nicole Lamoreaux | Nurse Practitioner | 630 S 1810 W, Orem, UT 84058-4969 | 2016-08-24 |
1770980666 | Rochelle Petersen Clive | Nurse Practitioner | 337 E University Pkwy, Orem, UT 84058-7639 | 2014-11-21 |
1720497597 | Derrick Evan Pickering | Nurse Practitioner | 800 W University Parkway, Sc 221, Orem, UT 84058-3305 | 2014-08-06 |
Find all providers in OREM |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.