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General NPI Number Information
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NPI Number | 1811531361
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Entity Type | Individual
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Provider Name | DEBRA BENNETT PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 73315 HAYSTACK RD
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City | PALM DESERT
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State | CA
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Zip | 92260-6058
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Country | US
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Telephone | 310-403-7681
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Fax |
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Provider Business Mailing Address
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Address Line | 42335 WASHINGTON ST STE 151
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City | PALM DESERT
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State | CA
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Zip | 92211-8004
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Country | US
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Telephone | 310-403-7681
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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 | 95013936
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 644128
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License Number State | CA
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