Healthcare Provider Details

I. General information

NPI: 1669023776
Provider Name (Legal Business Name): CHRISTINA SHARON BENSFIELD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 TECHNOLOGY CT STE 105
RIVERSIDE CA
92507-2181
US

IV. Provider business mailing address

PO BOX 19000
CLOVIS NM
88102-9000
US

V. Phone/Fax

Practice location:
  • Phone: 951-686-8500
  • Fax:
Mailing address:
  • Phone: 575-769-4490
  • Fax: 575-769-4330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberM-10872
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: