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TANYA ANTONIETA BENITEZ FNP

>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1164891289

Individual Registrant:
 TANYA ANTONIETA BENITEZ FNP
Gender: F
Sole Proprietor

Location and contact information for practice:
12021 JACARANDA AVE SUITE 101 HESPERIA, CA 92345-4978 US
Tel: 760-956-5057  Fax: 760-948-2179

Contact information for business:
12021 JACARANDA AVE STE 101  HESPERIA, CA 92345-4978 US
Tel: 760-956-5057  Fax: 760-948-2179

Registration Information:
NPI: 1164891289
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
CA95000274

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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