Individual
JUSTIN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
444 GEORGIA ST, VALLEJO, CA 94590-6005
(707) 563-0157
Mailing address
444 GEORGIA ST, VALLEJO, CA 94590-6005
(707) 563-0157
(707) 635-8215
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/26/2025
Last updated
05/27/2026
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