Provider Demographics
NPI:1568638252
Name:HERNANDEZ-BENEDICT, CAROLINE ANN
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:ANN
Last Name:HERNANDEZ-BENEDICT
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 1:69295 MCCALLUM WAY
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-2990
Mailing Address - Country:US
Mailing Address - Phone:760-992-8166
Mailing Address - Fax:
Practice Address - Street 1:69295 MCCALLUM WAY
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-2990
Practice Address - Country:US
Practice Address - Phone:760-992-8166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management