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General NPI Number Information
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NPI Number | 1568181022
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Entity Type | Individual
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Provider Name | EDGAR RODOLFO BENAVIDEZ RN
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Gender | Male
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Dates
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Enumeration Date | 08/26/2022
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 23845 MCBEAN PKWY
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City | VALENCIA
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State | CA
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Zip | 91355-2083
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Country | US
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Telephone | 661-200-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 43361 GADSDEN AVE APT 330
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City | LANCASTER
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State | CA
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Zip | 93534-6139
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Country | US
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Telephone | 661-537-5932
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95038959
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 95213132
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License Number State | CA
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