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General NPI Number Information
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NPI Number | 1154608776
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Entity Type | Individual
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Provider Name | CRISTINA DEL REFUGIO BENITEZ M.S.W
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Gender | Female
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 483 N AVIATION BLVD
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City | EL SEGUNDO
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State | CA
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Zip | 90245-2808
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Country | US
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Telephone | 310-653-2873
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Fax |
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Provider Business Mailing Address
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Address Line | 483 N AVIATION BLVD
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City | EL SEGUNDO
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State | CA
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Zip | 90245-2808
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Country | US
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Telephone | 310-653-6860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | IS Q1-0001475
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License Number State | DE
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