Patti A Bennett-Deguzman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17493 Issued in CA

Practice address

11515 El Camino Real
Suite 160
San Diego, CA 92130-3038

Phone

(619) 838-5989

Fax

(858) 356-0412

NPI assigned

Apr 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801015227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11515 EL CAMINO REAL",
            "address_2": "SUITE 160",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303038",
            "telephone_number": "619-838-5989",
            "fax_number": "858-356-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 EL CAMINO REAL",
            "address_2": "SUITE 160",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303038",
            "telephone_number": "619-838-5989",
            "fax_number": "858-356-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT-DEGUZMAN",
        "first_name": "PATTI",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "17493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Benn, LMFT
• Shelley Joyce Benn
• Dawn Benner
• Jon Michael Benner, PHARM.D
• Bennett Dental Corporation
• Shannon Bennett-Gunderson
• Alexandra Sloane Bennett, LCSW
• Amy Kristina Bennett, RN, NP
• Andrew Kenneth Bennett, RADT
• Bessie Bennett

• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.