DR. DOMINIQUE BENAVIDEZ PH.D. NPI 1740309525

NPI Information

NPI: 1740309525
Provider Name: DR. DOMINIQUE BENAVIDEZ, PH.D.
Classification: Psychologist - 103TM1800X
Entity Type: Individual

Specialization: Intellectual and Developmental Disabilities

PECOS Registration: Yes

Address:
335 REDONDO AVE
LONG BEACH, CA
ZIP 90814
Phone: (562) 434-3030
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DR. Dominique Benavidez, PH.D. is an intellectual and developmental disabilities in Long Beach, CA with 19 years of experience. DR. Dominique Benavidez, PH.D. NPI is 1740309525. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

335 REDONDO AVE
LONG BEACH, CA
ZIP 90814
Phone: (562) 434-3030
Fax: (562) 434-3212

The NPI 1740309525 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Psychotherapy, 60 minutes (HCPCS:90837)
Psychotherapy, 45 minutes (HCPCS:90834)

The enumeration date for this NPI number is 3/29/2007 and was last updated on 6/27/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TA0700X	Psychologist	Adult Development & Aging	22620	CALIFORNIA	No
2	103TB0200X	Psychologist	Cognitive & Behavioral	22620	CALIFORNIA	No
3	103TC0700X	Psychologist	Clinical	22620	CALIFORNIA	No
4	103TC2200X	Psychologist	Clinical Child & Adolescent	22620	CALIFORNIA	No
5	103TM1800X	Psychologist	Intellectual and Developmental Disabilities	RPS2005098	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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