Rebecca Rose Bonneville, NURSE PRACTITIONER in Woodland Hills, CA

Rebecca Rose Bonneville, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Woodland Hills, California. Her current practice location is 22704 Ventura Blvd Unit 115, Woodland Hills, California. You can reach out to her office (for appointments etc.) via phone at (323) 900-5091.

Rebecca Rose Bonneville is licensed to practice in California (license number 1821424375) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1821424375.

Contact Information

	Rebecca Rose Bonneville, NURSE PRACTITIONER
	22704 Ventura Blvd Unit 115, Woodland Hills, CA 91364-1333
	(323) 900-5091
	(323) 538-6512

Map and Direction

Provider's Profile

Full Name	Rebecca Rose Bonneville
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	22704 Ventura Blvd Unit 115, Woodland Hills, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1821424375
Provider Enumeration Date: 09/16/2013
Last Update Date: 01/27/2025

Medicare PECOS Information:

PECOS PAC ID: 9335413004
Enrollment ID: I20190529003203

Medical Identifiers

Medical identifiers for Rebecca Rose Bonneville such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1821424375	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	1821424375 (California)	Primary
101YM0800X	Counselor - Mental Health	(* (Not Available))	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	22278 (Tennessee)	Secondary
101YA0400X	Counselor - Addiction (substance Use Disorder)	(California)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Rebecca Rose Bonneville allows following entities to bill medicare on her behalf.

Entity Name	Mellow Medical Inc A Professional Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407275886 PECOS PAC ID: 3375767403 Enrollment ID: O20140611002222

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Rebecca Rose Bonneville is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Rebecca Rose Bonneville, NURSE PRACTITIONER 22704 Ventura Blvd Unit 115, Woodland Hills, CA 91364-1333 Ph: (323) 900-5091	Rebecca Rose Bonneville, NURSE PRACTITIONER 22704 Ventura Blvd Unit 115, Woodland Hills, CA 91364-1333 Ph: (323) 900-5091

Reviews and Comments

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Rebecca Rose Bonneville, NURSE PRACTITIONER - Medicare Nurse Practitioner in Woodland Hills, CA