DR. DOMINIQUE BENAVIDEZ (NPI# 1740309525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740309525 |
| Entity Type | Individual |
| Full Name | DR. DOMINIQUE BENAVIDEZ |
| Credential | PH.D. |
| Practice Address |
335 Redondo Ave Long Beach CA 90814 |
| Mailing Address |
904 Silver Spur Rd # 297 Rolling Hills Estates CA 90274-3800 |
| Practice Telephone | 5624343030 |
| Practice Fax Number | 5624343212 |
| Mailing Telephone | 3103730800 |
| Mailing Fax Number | 3103730868 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2018-06-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
22620 | CA | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
22620 | CA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
22620 | CA | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
22620 | CA | Behavioral Health & Social Service Providers |
| Y | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
RPS2005098 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 335 Redondo Ave, Long Beach, CA 908142652 | 5624343030 | 5624343212 |
| Street Address |
335 REDONDO AVE |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184659989 | William Edward Feuerborn | Social Worker | 335 Redondo Ave, Long Beach, Long Beach, CA 90814-2652 | 2006-07-11 |
| 1083238356 | Rogachevsky Marriage and Family Therapy | Marriage & Family Therapist | 335 Redondo Ave, Long Beach, CA 90814-2652 | 2020-06-02 |
| 1982941902 | Branko Radisavljevic M.d. Inc. | Psychiatry & Neurology | 335 Redondo Ave, Long Beach, CA 90814-2652 | 2013-01-10 |
| 1508935255 | Shane Lex Gomes | Psychologist | 335 Redondo Ave, Long Beach, CA 90814-2652 | 2006-11-07 |
| 1609886571 | Branko S Radisavljevic | Psychiatry & Neurology | 335 Redondo Ave, Long Beach, CA 90814-2652 | 2006-08-09 |
| 1043220940 | Mark C Fairchild | Psychiatry & Neurology | 335 Redondo Ave, Long Beach, CA 90814-2652 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164797056 | Recovery At Sea | Community/Behavioral Health | 2345 East 4th Street, Long Beach, CA 90814 | 2012-03-12 |
| 1982869616 | James R Gaither Jr. | Rehabilitation Practitioner | 2017 E 4th Street, Long Beach, CA 90814 | 2008-07-22 |
| 1760676274 | Charles Edward Criddle | Chiropractor | 352 Newport Ave, Long Beach, CA 90814 | 2007-08-29 |
| 1891911459 | Ting-wey Yen | Dentist | 319 Redondo Ave., Long Beach, CA 90814 | 2007-04-18 |
| 1194850495 | Donna Marie Camagay Calima | Dentist | 389 Redondo Ave, Long Beach, CA 90814 | 2007-02-23 |
| 1366595332 | Roger Justin Wood | Marriage & Family Therapist | 3424 E 4th St, Long Beach, CA 90814 | 2007-01-20 |
| 1467558338 | Rudy Steven Mendoza | Dentist | 392 Redondo Ave, Long Beach, CA 90814 | 2006-09-16 |
| 1578670766 | Seany Renfrow | Psychologist | 5170 Colorado, Long Beach, CA 90814 | 2006-08-24 |
| 1245210368 | Johnny L Triplett | Anesthesiology | 4674 East Barker Way, Long Beach, CA 90814 | 2006-01-17 |
| 1992960371 | Maria Veronica Uvero Racelis | Rehabilitation Practitioner | 2017 E 4th Street, Long Beach, CA 90814 | 2008-07-24 |
| Find all providers in zip 90814 | ||||
| Taxonomy Code | 103TM1800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Mental Retardation & Developmental Disabilities |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003476359 | Samuel Doong | Psychologist | 2514 Piedmont Ave Apt 105, Berkeley, CA 94704-3108 | 2019-06-18 |
| 1437634482 | New Horizons: Serving Individuals With Special Needs | Psychologist | 19031 Arminta Street, Reseda, CA 91335-1104 | 2018-09-26 |
| 1679086417 | B & D Assessment and Consulting Services, Inc. | Psychologist | 26565 West Agoura Rd Ste 200, Calabasas, CA 91302-1990 | 2017-11-15 |
| 1235593690 | Wayne Kilthau | Psychologist | 5301 Gerine Blossom Dr, San Jose, CA 95123-2118 | 2016-04-11 |
| 1588024103 | Kristin Bria | Psychologist | 150 Glen Cove Marina Rd E, Vallejo, CA 94591-7292 | 2016-02-24 |
| 1477921450 | Haleigh Scott | Psychologist | 3626 Fair Oaks Blvd Ste 100, Sacramento, CA 95864-7200 | 2015-09-09 |
| 1235543265 | Verbal Behavior Associates | Psychologist | 15373 Innovation Dr., Suite 200, San Diego, CA 92128 | 2014-06-18 |
| 1700290962 | New Directions for Young Adults - California | Psychologist | 100 Longbrook Way, Ste. 20, Pleasant Hill, CA 94523 | 2014-06-16 |
| 1518383520 | Tammy Brandt | Psychologist | 5016 North Parkway Calabasas, 215, Calabasas, CA 91302 | 2014-03-14 |
| 1548501323 | Independent Consulting Services | Psychologist | 124 Whispering Oaks Dr, Glendora, CA 91741-3988 | 2013-03-05 |
| Find all providers with the same taxonomy | ||||
| City | LONG BEACH |
| Zip Code | 90814 |
Please comment or provide details below to improve the information on DR. DOMINIQUE BENAVIDEZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.