Individual
BERNESTINE C BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 FUNDY BAY, ALAMEDA, CA 94502-7926
(510) 612-9605
Mailing address
105 FUNDY BAY, ALAMEDA, CA 94502-7926
(510) 612-9605
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
03/21/2022
Last updated
03/21/2022
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