Provider Demographics
NPI:1487993101
Name:LMB THERAPY ASSOCIATES
Entity type:Organization
Organization Name:LMB THERAPY ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:MELANIA
Authorized Official - Last Name:BONDONNO
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:707-647-7007
Mailing Address - Street 1:1201 GLEN COVE PKWY
Mailing Address - Street 2:UNIT 203
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-7172
Mailing Address - Country:US
Mailing Address - Phone:707-647-7007
Mailing Address - Fax:
Practice Address - Street 1:1201 GLEN COVE PKWY
Practice Address - Street 2:UNIT 203
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-7171
Practice Address - Country:US
Practice Address - Phone:707-647-7007
Practice Address - Fax:707-773-7307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 48212251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1326341942OtherLAURA BONDONNO MFT