Provider Demographics
NPI:1568737096
Name:BENAVIDES, ARLES ARISTEO (BA)
Entity Type:Individual
Prefix:MR
First Name:ARLES
Middle Name:ARISTEO
Last Name:BENAVIDES
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13710 MARQUITA LN
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-4373
Mailing Address - Country:US
Mailing Address - Phone:562-972-1265
Mailing Address - Fax:626-968-9892
Practice Address - Street 1:147 S 6TH AVE
Practice Address - Street 2:SPIRITT FAMILY SERVICES, LA PUENTE CENTER
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91746-2914
Practice Address - Country:US
Practice Address - Phone:626-968-0791
Practice Address - Fax:626-968-9892
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator