Suzanne Tavoularis Benjestorf, MFT, PHD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MFT31894 Issued in CA

Practice address

3937 9TH Ave
San Diego, CA 92103-3210

Phone

(619) 298-2401

NPI assigned

Jul 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1346405693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 83912",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921383912",
            "telephone_number": "858-717-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3937 9TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033210",
            "telephone_number": "619-298-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJESTORF",
        "first_name": "SUZANNE",
        "middle_name": "TAVOULARIS",
        "credential": "MFT, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20520",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFT31894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey Antonio Benjamin, MD
• Laurel R Benjamin
• Riley Benjamin
• Stephanie Brooke Benjamin
• Sydney Benjamin
• Christen Marie Benke, DO
• Keren Benmoshe
• Courtney Benn, LMFT
• Shelley Joyce Benn
• Dawn Benner

• Mental Health Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.