Provider Demographics
NPI:1487800546
Name:HELMS, BONNY MATHE (MFT)
Entity type:Individual
Prefix:
First Name:BONNY
Middle Name:MATHE
Last Name:HELMS
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 1:2616 LA MESA WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0337
Mailing Address - Country:US
Mailing Address - Phone:916-480-0344
Mailing Address - Fax:
Practice Address - Street 1:2616 LA MESA WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0337
Practice Address - Country:US
Practice Address - Phone:916-480-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41085106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist