Individual
DR. BENJAMIN ISAAC FELLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5405 MOREHOUSE DR, STE 120, SAN DIEGO, CA 92121-4723
(713) 826-1350
(858) 408-9422
Mailing address
5405 MOREHOUSE DR, STE 120, SAN DIEGO, CA 92121-4723
(713) 826-1350
(858) 408-9422
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
28401
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13851419
CAQH
CA
Enumeration date
06/29/2016
Last updated
10/04/2016
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