ELIZABETH ADA BENNETT


Address: 1411 S Rimpau Ave, Suite 202, Corona, CA 92881
Phone: 9512836635

ELIZABETH ADA BENNETT (NPI# 1982734489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1982734489
Entity Type Individual
Full Name ELIZABETH ADA BENNETT
Other Name DR. ELIZABETH H BENNETT
Credential PSYD
Practice Address 1411 S Rimpau Ave
Suite 202
Corona
CA 92881
Mailing Address 1240 E Ontario Ave
Suite 102-202
Corona
CA 92881
Practice Telephone 9512836635
Practice Fax Number 9512788828
Mailing Telephone 9512836635
Mailing Fax Number 9512788828
Enumeration Date 2007-03-06
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
PSY16715 CA Behavioral Health & Social Service Providers

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Office Location

Street Address 1411 S RIMPAU AVE
SUITE 202
City CORONA
State CA
Zip Code 92881

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NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

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Competitor

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City CORONA
Zip Code 92881

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Dataset Information

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.

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