Provider Demographics
NPI:1689921843
Name:HESS, BENTLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:BENTLEY
Middle Name:
Last Name:HESS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-0063
Mailing Address - Country:US
Mailing Address - Phone:323-388-5036
Mailing Address - Fax:
Practice Address - Street 1:99 ALMADEN BLVD STE 600
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-1605
Practice Address - Country:US
Practice Address - Phone:408-402-4385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY31364103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist