Individual
BREANNE BENEDICT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2185 W GRANT LINE RD, TRACY, CA 95377-7309
(209) 839-6299
Mailing address
2185 W GRANT LINE RD, TRACY, CA 95377-7309
(209) 839-6233
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
30435
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/18/2014
Last updated
01/03/2022
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