Individual provider Active NPI

Dawn Benner

  • Student in an Organized Health Care Education/Training Program
  • San Diego, CA
National Provider Identifier
1417548934
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
995 Gateway Center Way Ste 300
San Diego, CA 92102-4550
Phone
(619) 398-2156
Fax
(619) 398-2168
NPI assigned
Jan 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Mental Health Counselor 101YM0800X
Case Manager/Care Coordinator 171M00000X
Student in an Organized Health Care Education/Training Program 390200000X CA Primary
Rehabilitation Practitioner 225400000X CA

Addresses

Primary practice location

995 Gateway Center Way Ste 300
San Diego, CA 92102-4550

Mailing address

1963 4TH Ave
San Diego, CA 92101-2394
Phone (619) 233-3432

Other practice location 1

1063 McGaw
Suite 100
Irvine, CA 92614-5554
Phone (323) 431-6047

Other practice location 2

1963 4th Ave
San Diego, CA 92101-2394
Phone (619) 233-3432

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Research Foundation Inc Case Manager/Care Coordinator Past Accepting new patients
Community Research Foundation Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1417548934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012394",
            "telephone_number": "619-233-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 GATEWAY CENTER WAY STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024550",
            "telephone_number": "619-398-2156",
            "fax_number": "619-398-2168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1063 McGaw",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926145554",
            "country_code": "US",
            "telephone_number": "323-431-6047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1963 4th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921012394",
            "country_code": "US",
            "telephone_number": "619-233-3432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNER",
        "first_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.