Individual
MR. BENNIE ISAIAH HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16800 DEVONSHIRE ST STE 301, GRANADA HILLS, CA 91344-7410
(818) 425-2261
Mailing address
14625 MAGNOLIA BLVD APT 12, SHERMAN OAKS, CA 91403-1453
(706) 761-8729
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
94027270
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94027270
BOARD OF PSYCHOLOGY
CA
Enumeration date
01/20/2023
Last updated
02/05/2025
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