Healthcare Provider Details

I. General information

NPI: 1689921843
Provider Name (Legal Business Name): BENTLEY HESS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 10/02/2023
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 ALMADEN BLVD STE 600
SAN JOSE CA
95113-1605
US

IV. Provider business mailing address

PO BOX 63
RANCHO SANTA FE CA
92067-0063
US

V. Phone/Fax

Practice location:
  • Phone: 408-402-4385
  • Fax:
Mailing address:
  • Phone: 323-388-5036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY31364
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: