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Individual

MR. BENJAMIN FRANK CORNELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
31625 HIGHWAY 101, SOLEDAD, CA 93960
(831) 678-5500
Mailing address
166 HEAD ST, SOLEDAD, CA 93960-3600
(402) 202-3209

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
26900
CA
1041C0700X
Clinical Social Worker
Primary
61515
CA

Other

Enumeration date
01/05/2011
Last updated
06/13/2023
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