Provider Demographics
NPI:1831239839
Name:BONORA, TERA E (PSYD)
Entity type:Individual
Prefix:DR
First Name:TERA
Middle Name:E
Last Name:BONORA
Suffix:
Gender:F
Credentials:PSYD
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Mailing Address - Street 1:375 LAGUNA HONDA BLVD
Mailing Address - Street 2:LAGUNA HONDA HOSPITAL AND REHAB CENTER, MEDICAL SVCS
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1411
Mailing Address - Country:US
Mailing Address - Phone:415-759-3348
Mailing Address - Fax:415-759-3012
Practice Address - Street 1:375 LAGUNA HONDA BLVD
Practice Address - Street 2:LAGUNA HONDA HOSPITAL AND REHAB CENTER, MEDICAL SVCS
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1411
Practice Address - Country:US
Practice Address - Phone:415-759-4576
Practice Address - Fax:415-759-4587
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2014-01-23
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Provider Licenses
StateLicense IDTaxonomies
CAPSY19991103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist