Individual provider · NPI-1

Jason Bonilla

Occupational Therapist · Pomona, CA

NPI number1649107574
StatusActive
Last updated in NPPESMay 5, 2026

Details

NPI
1649107574
Entity type
Individual (NPI-1)
Name
Jason Bonilla
Sex
Male
Sole proprietor
Yes
Enumeration date
May 5, 2026
Certification date
May 5, 2026
Last updated
May 5, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist21249CAYes

Practice location

39 Hunter Point Rd
Pomona, CA 91766-4959

Phone 909-670-6416

Mailing address

39 Hunter Point Rd
Pomona, CA 91766-4959

Phone 909-670-6416

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