Dominique Benavidez Psychology Consultant and Associates

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY22620 Issued in CA

Legal business name

DOMINIQUE BENAVIDEZ PSYCHOLOGY CONSULTANT AND ASSOCIATES

Practice address

24520 Hawthorne Blvd
Ste. 216
Torrance, CA 90505-6800

Phone

(310) 373-0800

Fax

(310) 373-0880

NPI assigned

Mar 22, 2013

Organization subpart

No

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

Authorized official

Name

Dominique Benavidez, PHDNPI 1740309525

Title

Owner

Phone

(310) 373-0800

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dominique Benavidez, PH.D.

  • Intellectual & Developmental Disabilities Psychologist
  • Long Beach, CA
  • NPI 1740309525

  Clinical

  NPD (past) Authorized official

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363910400000",
    "number": "1609118165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 SILVER SPUR RD",
            "address_2": "#297",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743800",
            "telephone_number": "310-373-0800",
            "fax_number": "310-373-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24520 HAWTHORNE BLVD",
            "address_2": "STE. 216",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056800",
            "telephone_number": "310-373-0800",
            "fax_number": "310-373-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINIQUE BENAVIDEZ PSYCHOLOGY CONSULTANT AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-22",
        "last_updated": "2013-03-22",
        "status": "A",
        "authorized_official_last_name": "BENAVIDEZ",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-373-0800",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CC615A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Kahiwalani Domingo, OTD, OTR/L
• Beatriz Dominguez Sanchez
• Gerardo Ernesto Dominguez
• Jacqueline Antonia Elba Dominguez, DO
• Nayeli Dominguez
• Mary Jo Donahue, M.D.
• Donald F Borden MD Inc
• Donald Okada, MD Inc
• Donald W. Inadomi, MD, Inc
• Abigail Tadlock Donegan, M.S.

• Clinical Psychologist in Torrance, CA
• Providers in Torrance, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.