Alice Lee A Benjamin, ACNS-BC, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95016952 Issued in CA

Practice address

11325 Riverside Dr
Toluca Lake, CA 91602-1220

Phone

(619) 252-8796

NPI assigned

Sep 20, 2020

Last updated

Sep 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1600560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725148800000",
    "number": "1922614411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11333 MOORPARK ST # 30",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916022618",
            "telephone_number": "619-813-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11325 RIVERSIDE DR",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916021220",
            "telephone_number": "619-252-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "ALICE LEE",
        "middle_name": "A",
        "credential": "ACNS-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-20",
        "last_updated": "2024-09-01",
        "certification_date": "2024-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704326451",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "TPAN2621",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F353226-01",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016952",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "3231",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahriyar Banihashemi, DDS
• Bassiri & Huizenga Chiropractic Corporation (Toluca Lake Chiropractic)
• BC Pharmacy Incorporated
• Beacon Treatment Navigators LLC
• Bellamy Home Health, Inc.
• Georgia Berges, MFT
• Beverly Radiology Medical Group (Burbank Advanced Imaging Center Med Group)
• Esteban D Bonilla, DDS
• Allen Garcia Bordman, FNP-C
• Karen Elise Butler, D.O.

• Family Nurse Practitioner in Toluca Lake, CA
• Providers in Toluca Lake, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2024; 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.