Healthcare Provider Details

I. General information

NPI: 1841524667
Provider Name (Legal Business Name): CECILIA BENDIMEZ AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2009
Last Update Date: 05/07/2022
Certification Date: 05/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 THE CITY DR S FL 2
ORANGE CA
92868-3205
US

IV. Provider business mailing address

301 THE CITY DR S FL 2
ORANGE CA
92868-3205
US

V. Phone/Fax

Practice location:
  • Phone: 714-935-6363
  • Fax: 714-935-8112
Mailing address:
  • Phone: 714-935-6363
  • Fax: 714-935-8112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number131647
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: