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General NPI Number Information
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NPI Number | 1962920462
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Entity Type | Individual
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Provider Name | ANDREA BENBASSAT MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 12100 WILSHIRE BLVD STE 1750
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City | LOS ANGELES
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State | CA
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Zip | 90025-7101
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Country | US
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Telephone | 818-646-7790
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Fax |
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Provider Business Mailing Address
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Address Line | 5048 NOELINE AVE
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City | ENCINO
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State | CA
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Zip | 91436-1217
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Country | US
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Telephone | 818-645-1668
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP23660
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License Number State | CA
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