DR. DOMINIQUE BENAVIDEZ PH.D. NPI 1740309525

NPI Information

  • NPI: 1740309525
  • Provider Name: DR. DOMINIQUE BENAVIDEZ, PH.D.
  • Classification: Psychologist - 103TM1800X
  • Specialization: Intellectual and Developmental Disabilities
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 335 REDONDO AVE
    LONG BEACH, CA
    ZIP 90814
  • Phone: (562) 434-3030

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NPI Details

DR. Dominique Benavidez, PH.D. is an intellectual and developmental disabilities in Long Beach, CA with 21 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, 45 minutes (HCPCS:90834)
  • Psychiatric diagnostic evaluation (HCPCS:90791)

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
1103TA0700XPsychologistAdult Development & Aging22620CALIFORNIANo
2103TB0200XPsychologistCognitive & Behavioral22620CALIFORNIANo
3103TC0700XPsychologistClinical22620CALIFORNIANo
4103TC2200XPsychologistClinical Child & Adolescent22620CALIFORNIANo
5103TM1800XPsychologistIntellectual and Developmental DisabilitiesRPS2005098CALIFORNIAYes

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: 11/21/2025

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