| Joanna R Benavidez Phd Clinical Psychologist | |
|
2831 Camino Del Rio S Ste 103 San Diego CA 92108-3827 | |
| (760) 694-0327 | |
| Not Available |
| Full Name | Joanna R Benavidez Phd Clinical Psychologist |
|---|---|
| Speciality | Clinic/Center |
| Location | 2831 Camino Del Rio S Ste 103, San Diego, California |
| Authorized Official Name and Position | Joanna Rose Benavidez (OWNER) |
| Authorized Official Contact | 7606940327 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joanna R Benavidez Phd Clinical Psychologist 2831 Camino Del Rio S Ste 103 San Diego CA 92108-3827 Ph: (760) 694-0327 | Joanna R Benavidez Phd Clinical Psychologist 2831 Camino Del Rio S Ste 103 San Diego CA 92108-3827 Ph: (760) 694-0327 |
| NPI Number | 1962029371 |
|---|---|
| Provider Enumeration Date | 07/01/2020 |
| Last Update Date | 09/16/2023 |
| Certification Date | 09/16/2023 |
| Medicare PECOS PAC ID | 3971914029 |
|---|---|
| Medicare Enrollment ID | O20201123000754 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962029371 | NPI | - | NPPES |
| Provider Name | Joanna Rose Benavidez |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1922525542 PECOS PAC ID: 3678812294 Enrollment ID: I20190226002357 |
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