CONRAD BONILLA PMHNP
NPI 1235764630
Nurse Practitioner - Psychiatric/Mental Health in Long Beach, CA

Q: What is Conrad Bonilla's NPI number?

The NPI number for Conrad Bonilla is 1235764630. It was assigned to this individual provider in the NPPES registry on March 5, 2020.

Q: What is Conrad Bonilla's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Conrad Bonilla was last updated on February 5, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 05, 2020PECOS Enrolled

1775 CHESTNUT AVE, LONG BEACH, CA 90813(562) 599-8444 Get Directions Write a Review

NPPES record last updated: February 5, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 5, 2026, Mar 5, 2020 (2 updates tracked since 2020).

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About Conrad Bonilla Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONRAD BONILLA PMHNP (NPI 1235764630) is an individual psychiatric/mental health provider in Long Beach, California, licensed in California (95036333) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1235764630

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameCONRAD BONILLACredential: PMHNP

Location Address1775 CHESTNUT AVELong Beach, CA 90813-1674

Mailing Address980 S Los Robles AvePasadena, CA 91106-4362 · (323) 606-3189

Phone(562) 599-8444

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateMarch 5, 2020

Last NPPES UpdateFebruary 5, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 5, 2026

✔ NPI 1235764630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95036333

1775 CHESTNUT AVE, Long Beach, CA 90813

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Secondary Practice Locations 2

Location 1800 S Main StCorona, CA 92882-3420 · Phone (951) 737-4343

Location 21680 E 120th StLos Angeles, CA 90059-3026 · Phone (424) 338-8000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Conrad Bonilla Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2163909953

PECOS Enrollment IDI20260122004004

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90813 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YESENIA CHACON

Counselor (Addiction (Substance Use Disorder))