Healthcare Provider Details

I. General information

NPI: 1457865685
Provider Name (Legal Business Name): DENISE BENITEZ RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N PARK AVE
AVENAL CA
93204-1425
US

IV. Provider business mailing address

1225 S 7TH AVE
AVENAL CA
93204-2301
US

V. Phone/Fax

Practice location:
  • Phone: 559-717-0405
  • Fax:
Mailing address:
  • Phone: 559-386-9083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: