Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Bonn Demetrio Miso Hidalgo III

Individual provider Clinical Social Worker · NPI 1770257297

Mr. Bonn Demetrio Miso Hidalgo III is a Clinical Social Worker in Culver City, California. Licensed in California. Registered with an NPI since 2021.

Licensed in
CA
In the registry since
2021
Specialties on file
5
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Practice location Address checks out

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone: (310) 390-6612
Fax: (310) 398-5690
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 137368 (CA)
Clinical Social Worker Taxonomy 1041C0700X
Mental Health Counselor Taxonomy 101YM0800X
Case Manager/Care Coordinator Taxonomy 171M00000X
Social Worker Taxonomy 104100000X · Licence 109311 (CA)

Record details

NPI number1770257297
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 7, 2021
Last updated in NPPESMarch 4, 2026
Certification dateMarch 4, 2026

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