Individual provider Active NPI

Amanda Rose Benvenuto, MSN PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Newport Beach, CA
National Provider Identifier
1003730540
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95040623 Issued in CA
Practice address
1000 Quail St Ste 245
Newport Beach, CA 92660-2749
Phone
(949) 594-4795
NPI assigned
Aug 6, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95040623 CA Primary

Addresses

Primary practice location

1000 Quail St Ste 245
Newport Beach, CA 92660-2749

Mailing address

24036 Continental Dr
Canyon Lake, CA 92587-7757
Phone (949) 500-2785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1785974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1003730540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24036 CONTINENTAL DR",
            "city": "CANYON LAKE",
            "state": "CA",
            "postal_code": "925877757",
            "telephone_number": "949-500-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 QUAIL ST STE 245",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602749",
            "telephone_number": "949-594-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENVENUTO",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "credential": "MSN PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-06",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95040623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.