Individual
BENJAMIN DUARTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5015 EAGLE ROCK BLVD STE 208, LOS ANGELES, CA 90041-2087
(323) 312-5454
Mailing address
5015 EAGLE ROCK BLVD STE 208, LOS ANGELES, CA 90041-2087
(323) 312-5454
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-65442
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
NA
CA
Enumeration date
06/22/2021
Last updated
05/23/2023
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