Individual
JESSICA MARIE BENAVIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 POPLAR AVE APT 1, REDWOOD CITY, CA 94061-3069
(650) 520-6898
Mailing address
118 POPLAR AVE APT 1, REDWOOD CITY, CA 94061-3069
(650) 520-6898
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 10631
CA
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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