MEDICARE: MRS. CHEN BENTOV-HAMAM LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LMFT79580	CA

General Provider Information

NPI Number	:	1497912562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHEN BENTOV-HAMAM LMFT

Provider Business Mailing Address
First Line	:	2404 VILLA NUEVA WAY
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4457
Country	:	US
Telephone Number	:	650-964-2343
Fax Number	:

Provider Business Practice Location Address
First Line	:	2404 VILLA NUEVA WAY
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4457
Country	:	US
Telephone Number	:	650-964-2343
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	06/16/2014

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