Individual
JONATHAN COLEMAN BENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
555 SOQUEL AVE STE 330A, SANTA CRUZ, CA 95062-2342
(831) 313-2060
Mailing address
555 SOQUEL AVE STE 330A, SANTA CRUZ, CA 95062-2342
(831) 313-2060
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
CA
104100000X
Social Worker
ASW 68409
CA
104100000X
Social Worker
Primary
LCSW81650
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ91891Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
01
—
ZZZ92069Z
SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
CA
Enumeration date
10/02/2013
Last updated
10/24/2024
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