Individual
ALYSSA MIRANDA BENCOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 S SAN PEDRO ST, LOS ANGELES, CA 90013-2102
(866) 733-5924
Mailing address
500 S SAN PEDRO ST, LOS ANGELES, CA 90013-2102
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
116998
CA
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/12/2022
Last updated
08/10/2023
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