John Anthony Benjamin, PH.D.
Individual provider Active NPI Psychologist · Camp Pendleton, Ca, CA
NPI 1497763502 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497763502
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- PSY 06019 (CA)
- Practice address
- Naval Hospital, Camp Pendleton
Mental Health Clinic
Camp Pendleton, Ca, CA 92055-5191 - Phone
- (760) 725-1555
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6019 | CA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 06019 | CA | Yes |
Addresses
Primary practice location
Naval Hospital, Camp Pendleton
Mental Health Clinic
Camp Pendleton, Ca, CA 92055-5191
Mailing address
3529 Cannon Rd
Suite 2-B, #624
Oceanside, CA 92056-4980
Phone (951) 315-5538
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.