Provider Demographics
NPI:1114092384
Name:BENFANTE, RICHARD PAUL (LMFT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:PAUL
Last Name:BENFANTE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:PAUL
Other - Last Name:BENFANTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:730 MEDICAL CENTER CT
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6618
Mailing Address - Country:US
Mailing Address - Phone:619-729-5505
Mailing Address - Fax:
Practice Address - Street 1:6386 ALVARADO CT STE 210
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-4907
Practice Address - Country:US
Practice Address - Phone:619-729-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52141106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist