Individual
ELIZABETH ADA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1411 S RIMPAU AVE, SUITE 202, CORONA, CA 92881
(951) 283-6635
(951) 278-8828
Mailing address
1240 E ONTARIO AVE, SUITE 102-202, CORONA, CA 92881
(951) 283-6635
(951) 278-8828
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY16715
CA
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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