Provider Demographics
NPI:1568540748
Name:BENDINELLI, RODGER WAYNE
Entity Type:Individual
Prefix:MR
First Name:RODGER
Middle Name:WAYNE
Last Name:BENDINELLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23055 CECELIA
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2152
Mailing Address - Country:US
Mailing Address - Phone:949-716-3444
Mailing Address - Fax:
Practice Address - Street 1:405 W 5TH ST STE 212
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4522
Practice Address - Country:US
Practice Address - Phone:714-834-2125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist