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Individual

DR. ALICE ELIZABETH BENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
123 S ALVARADO ST, LOS ANGELES, CA 90057-2201
(213) 989-7700
(213) 989-7702
Mailing address
123 S ALVARADO ST, LOS ANGELES, CA 90057-2201
(213) 989-7700
(213) 989-7702

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
103TC0700X
Clinical Psychologist
Primary
PSY23516
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05-1007
MEDICARE ID
CA
01
05-1023
MEDICARE ID
CA
05
FHC70567F
CA
05
FHC71005F
CA
Enumeration date
07/10/2007
Last updated
12/14/2012
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