Individual
CANDACE VIRGINIA BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1480 TERRACITA DR, SAN BERNARDINO, CA 92404-1568
(310) 743-5035
Mailing address
526 S SAN PEDRO ST, LOS ANGELES, CA 90013-2102
(310) 743-5035
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/09/2008
Last updated
04/01/2014
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