Individual
DR. BENJAMIN G.L. FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
475-750 RICE CANYON ROAD, SUSANVILLE, CA 96130
(530) 251-5100
Mailing address
475-750 RICE CANYON ROAD, SUSANVILLE, CA 96130
(530) 251-5100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
25880
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25880
PSYCHOLOGIST LICENSE NUMBER
CA
Enumeration date
12/20/2007
Last updated
02/16/2023
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