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BONAVY SOM-KEO
NPI 1730628363
Marriage & Family Therapist in Gardena, CA

Active since February 15, 2017PECOS EnrolledAccepts Medicare Assignment
14112 S KINGSLEY DR, GARDENA, CA 90249(310) 217-7312 Get Directions Write a Review

NPPES record last updated: July 24, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 24, 2024, Jun 9, 2023, Feb 15, 2017 (3 updates tracked since 2017).

About Bonavy Som-keo NPPES

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

BONAVY SOM-KEO (NPI 1730628363) is an individual marriage & family therapist in Gardena, California, licensed in California (145519) and active in the NPI registry since February 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Fountain Valley, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1730628363
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameBONAVY SOM-KEO
Location Address14112 S KINGSLEY DRGardena, CA 90249-3018
Mailing Address14112 S Kingsley DrGardena, CA 90249-3018 · (310) 217-7312
Phone(310) 217-7312
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateFebruary 15, 2017
Last NPPES UpdateJuly 24, 20243 updates tracked since enumeration
NPPES CertifiedJuly 24, 2024
✔ NPI 1730628363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · 145519
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
14112 S KINGSLEY DR, Gardena, CA 90249
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Secondary Practice Location 1

Location 118350 Mount Langley St, Suite 140Fountain Valley, CA 92708-6900 · Phone (714) 450-4118 · Fax (714) 378-2631

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Bonavy Som-keo is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921447087
PECOS Enrollment IDI20240422003099
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.

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.

COASTAL ASIAN PACIFIC MENTAL HEALTH CENTER
Psychiatric Hospital
14112 S KINGSLEY DR
GARDENA, CA 90249
Los Angeles County (310) 217-7313
DR. NAM JIN CHOI
Rehabilitation Practitioner
14112 S KINGSLEY DR
GARDENA, CA 90249
Los Angeles County (213) 760-7061
SHERRY WANG
Social Worker (Clinical)
14112 S KINGSLEY DR
GARDENA, CA 90249
Los Angeles County (310) 217-7300
DR. JASON HUANG PHD
Psychologist (Clinical)
14112 S KINGSLEY DR
GARDENA, CA 90249
Los Angeles County (310) 217-7312
HANIYA SALEEM SYEDA
Social Worker (Clinical)
14112 S KINGSLEY DR
GARDENA, CA 90249
Los Angeles County (310) 217-7312
DR. ANDY CHUNG-WAI YING PSY.D.
Psychologist (Clinical)
14112 S KINGSLEY DR
GARDENA, CA 90249
Los Angeles County (310) 217-7312
THUY TRAN PHAM LCSW
Social Worker (Clinical)
14112 S KINGSLEY DR
GARDENA, CA 90249
Los Angeles County (310) 217-7312
JOSEPHINA RODRIGUEZ ASW
Social Worker (Clinical)
14112 S KINGSLEY DR
GARDENA, CA 90249
Los Angeles County (310) 533-6600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bonavy Som-keo's NPI number?

The NPI number for Bonavy Som-keo is 1730628363. It was assigned to this individual provider in the NPPES registry on February 15, 2017.

Where is Bonavy Som-keo located?

Bonavy Som-keo practices at 14112 S Kingsley Dr, Gardena, CA 90249. The listed phone number is (310) 217-7312.

What is Bonavy Som-keo's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Bonavy Som-keo enrolled in Medicare?

Yes. Bonavy Som-keo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Bonavy Som-keo was last updated on July 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.