Provider Demographics
NPI:1194331314
Name:BENSTEAD, MADISON
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:BENSTEAD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26672 FINO CT
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4318
Mailing Address - Country:US
Mailing Address - Phone:951-901-5305
Mailing Address - Fax:
Practice Address - Street 1:721 NEVADA ST STE 306
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-8053
Practice Address - Country:US
Practice Address - Phone:909-572-8280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula