Organization
CARISSA BENNETT, AUD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARISSA DARLENE BENNETT AU.D. (PRESIDENT)
(818) 500-0662
Entity
Organization
Contact information
Practice address
633 N CENTRAL AVE, SUITE #201, GLENDALE, CA 91203-1801
(818) 500-0662
(818) 500-0803
Mailing address
1477 DWIGHT DR, GLENDALE, CA 91207-1315
(818) 500-0662
(818) 500-0803
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU759
CA
Other
Enumeration date
04/02/2007
Last updated
08/22/2020
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