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LAURA BENAVIDEZ ASW

>> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1316425861

Individual Registrant:
 LAURA  BENAVIDEZ ASW
Gender: F
Not Sole Proprietor

Location and contact information for practice:
250 BON AIR RD UNIT B, FIRST FLOOR GREENBRAE, CA 94904 US
Tel: 415-473-7804  Fax: 415-473-2353

Contact information for business:
250 BON AIR RD UNIT B, FIRST FLOOR GREENBRAE, CA 94904 US
Tel: 415-473-7804  Fax: 415-473-2353

Registration Information:
NPI: 1316425861
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N104100000XBehavioral Health & Social Service Providers
Social Worker
CAASW90472
N390200000XStudent
Organized Health Care Education/Training Program
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
CAASW90472

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
1316425861CA05




HEALTH CARE JOBS CA - Page 1



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