Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bonavy Som-Keo

Individual provider Mental Health Counselor · NPI 1730628363

Bonavy Som-Keo is a Marriage and Family Therapist in Gardena, California. Qualified in 2018, 8 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in California.

Years since qualifying
8
Licensed in
CA
In the registry since
2017
Specialties on file
3
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Practice location Address checks out

14112 S Kingsley Dr
Gardena, CA 90249-3018
Phone: (310) 217-7312
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 18350 Mount Langley St, Fountain Valley, CA 92708-6900 — (714) 450-4118

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 145519 (CA)
Mental Health Counselor Taxonomy 101YM0800X
Marriage & Family Therapist Taxonomy 106H00000X

Record details

NPI number1730628363
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 15, 2017
Last updated in NPPESJuly 24, 2024
Certification dateJuly 24, 2024
Mailing address14112 S Kingsley Dr, Gardena, CA 90249-3018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Gardena