Individual provider Active NPI

Dinnia Mona Benjamin

  • Case Manager/Care Coordinator
  • Riverside, CA
National Provider Identifier
1558521864
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
11060 Magnolia Ave
Riverside, CA 92505-3047
Phone
(951) 358-6715
NPI assigned
Jun 10, 2008
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

11060 Magnolia Ave
Riverside, CA 92505-3047

Mailing address

1350 3Rd St
La Verne, CA 91750-5201
Phone (909) 596-5921

Other practice location 1

1350 3rd St
LA Verne, CA 91750-5201
Phone (909) 596-5921 ext. 3164

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1558521864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 3RD ST",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917505201",
            "telephone_number": "909-596-5921",
            "fax_number": "909-596-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11060 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053047",
            "telephone_number": "951-358-6715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 3rd St",
            "address_purpose": "LOCATION",
            "city": "LA Verne",
            "state": "CA",
            "postal_code": "917505201",
            "country_code": "US",
            "telephone_number": "909-596-5921 x3164",
            "fax_number": "909-596-3954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "DINNIA",
        "middle_name": "MONA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.