Erin Benesch, DO

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

20A12465 Issued in CA

Practice address

12511 Brookhurst St
2 FL
Garden Grove, CA 92840-4806

Phone

(714) 534-3681

NPI assigned

Mar 20, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Erin Moore Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of California, Irvine, California College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Harbor Psychiatry and Mental Health Professional CorporationGroup PAC ID 8729394572, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADEBAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Harbor Psychiatry & Mental Health, Professional Corporation

  • Psychiatry Physician
  • Newport Beach, CA
  • NPI 1780050054
  Medicare reassignment Care Compare group NPD
• Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1235283094
  Medicare reassignment NPD
• Central City Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Upland, CA
  • NPI 1174996318
  NPD

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

{
    "created_epoch": "1300579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1144529926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100B N TUSTIN AVE STE A",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12511 BROOKHURST ST",
            "address_2": "2 FL",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928404806",
            "telephone_number": "714-534-3681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927820221",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "947 S Anaheim Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928055591",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100B N Tustin Ave # A",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053505",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14642 Newport Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927806058",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENESCH",
        "first_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-20",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "20A12465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "MOORE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Child & Adolescent Psychiatry Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.