Provider Demographics
NPI:1083218804
Name:BENSINGER HAYNES, JUDITH ANN (MED, MA, LMFT 114669)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:BENSINGER HAYNES
Suffix:
Gender:F
Credentials:MED, MA, LMFT 114669
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 RISA RD STE A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3418
Mailing Address - Country:US
Mailing Address - Phone:925-683-3274
Mailing Address - Fax:
Practice Address - Street 1:954 RISA RD STE A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3418
Practice Address - Country:US
Practice Address - Phone:925-683-3274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114669103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling