Individual
ANDREA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2212 PLACENTIA AVE, COSTA MESA, CA 92627-7500
(949) 646-2271
(949) 646-1211
Mailing address
2212 PLACENTIA AVE, COSTA MESA, CA 92627-7500
(949) 646-2271
(949) 646-1211
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
01-063091
CA
Other
Enumeration date
07/31/2007
Last updated
07/31/2007
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