Jacqueline Paola Benavente, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF43802 Issued in CA

Practice address

11490 Burbank Blvd Ste 2D
North Hollywood, CA 91601-2392

Phone

(818) 821-0646

NPI assigned

Mar 7, 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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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.

• Sud Specialty Group - Ca

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  • NPI 1972138238
  Medicare reassignment

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1891826608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11490 BURBANK BLVD STE 2D",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012392",
            "telephone_number": "818-821-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11490 BURBANK BLVD STE 2D",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012392",
            "telephone_number": "818-821-0646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVENTE",
        "first_name": "JACQUELINE",
        "middle_name": "PAOLA",
        "name_prefix": "Miss",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF43802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gianina Blanca Beltran
• Stephanie Beltran
• Ben Assisted Living Inc
• Ben Congregate Living Inc
• Marla Diana Ben-Tov, LMFT, REAT
• Johnathon Alexander Bendy
• Beneficent Care Hospice Inc
• Lynne Suzanne Benhabib
• Maria Benitez
• Benjamin Broukhim M.D. a Medical Corp

• Marriage & Family Therapist in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.