Provider Demographics
NPI:1922898865
Name:BONIEL, STEFANIE BALDONADO
Entity type:Individual
Prefix:MS
First Name:STEFANIE
Middle Name:BALDONADO
Last Name:BONIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:STEFANIE
Other - Middle Name:BALDONADO
Other - Last Name:BONIEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 586
Mailing Address - Street 2:
Mailing Address - City:CAMINO
Mailing Address - State:CA
Mailing Address - Zip Code:95709-0586
Mailing Address - Country:US
Mailing Address - Phone:530-344-3758
Mailing Address - Fax:
Practice Address - Street 1:5494 PONY EXPRESS TRL
Practice Address - Street 2:
Practice Address - City:CAMINO
Practice Address - State:CA
Practice Address - Zip Code:95709-9403
Practice Address - Country:US
Practice Address - Phone:530-344-3758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)