Individual ProviderBonnie Jean GastonCounselorBehavioral Health & Social Service ProvidersPractice Address5436 S Broadway, Los Angeles, CA 90037-4126(323) 234-6261(323) 329-2542PECOS EnrollmentBased on the most recent information from CMS, provider Bonnie Jean Gaston does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 9:43 AM.Profile DetailsProvider ID1386922656Provider TypeIndividualFull NameGaston, Bonnie JeanGenderFemaleSole ProprietorYesEnumeration Date8/3/2011Last Updated8/3/2011Contact InformationPractice LocationPractice Address5436 S Broadway, Los Angeles, CA 90037-4126Phone(323) 234-6261FaxUnlisted FaxMailing LocationMailing Address240 W 46 St., Los Angeles, CA 90037-4126Phone(323) 329-2542FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YA0400XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer