Provider Demographics
NPI:1710760616
Name:BENSON, DEVON RACHELLE (LMFT)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:RACHELLE
Last Name:BENSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SAN CARLOS
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2410
Mailing Address - Country:US
Mailing Address - Phone:909-855-9278
Mailing Address - Fax:
Practice Address - Street 1:DEVON BENSON
Practice Address - Street 2:6 SAN CARLOS
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2410
Practice Address - Country:US
Practice Address - Phone:909-844-9278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101566101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health