Individual
CARMENCITA BENITO ARDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1675 N PERRIS BLVD, SUITE G1, PERRIS, CA 92571-4726
(951) 956-2400
(951) 956-2345
Mailing address
1675 N PERRIS BLVD, SUITE G1, PERRIS, CA 92571-4726
(951) 956-2400
(951) 956-2345
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP95001873
CA
363LF0000X
Family Nurse Practitioner
NP95001873
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EFF: 5/8/2015
—
CA
01
—
P01492737 - DU4034
RAILROAD MEDICARE
CA
Enumeration date
03/13/2015
Last updated
12/07/2016
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