Individual
LISA BENITEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12501 IMPERIAL HWY # 500B, NORWALK, CA 90650-3179
(562) 864-7821
(562) 864-7864
Mailing address
12501 IMPERIAL HWY # 500B, NORWALK, CA 90650-3179
(562) 864-7821
(562) 864-7864
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02870709
MEDI-CAL
CA
01
—
0287809
MEDI-CAL
CA
Enumeration date
07/15/2010
Last updated
05/21/2025
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