Individual
SANDRA JEAN BENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 E FESLER ST, SANTA MARIA, CA 93454-4404
(805) 922-6597
Mailing address
190 CARY PL, NIPOMO, CA 93444-5028
(805) 610-9012
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
91165
CA
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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