Provider Demographics
NPI:1437931714
Name:BENJAMIN, ZITA CHIDIMMA (NP)
Entity Type:Individual
Prefix:MRS
First Name:ZITA
Middle Name:CHIDIMMA
Last Name:BENJAMIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 E PENROD DR
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90746-1514
Mailing Address - Country:US
Mailing Address - Phone:323-245-2318
Mailing Address - Fax:
Practice Address - Street 1:850 E PENROD DR
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-1514
Practice Address - Country:US
Practice Address - Phone:323-245-2318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027651363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health