Provider Demographics
NPI:1306655402
Name:BENITEZ, ABBYGAIL ARACELY
Entity type:Individual
Prefix:
First Name:ABBYGAIL
Middle Name:ARACELY
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N CITRUS RANCH RD APT 108
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-2268
Mailing Address - Country:US
Mailing Address - Phone:714-854-4061
Mailing Address - Fax:
Practice Address - Street 1:100 N CITRUS RANCH RD APT 108
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-2268
Practice Address - Country:US
Practice Address - Phone:714-854-4061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst