Provider Demographics
NPI:1013618222
Name:BENITEZ-SERNA, CARLA FRANCISCA (16413 RAC)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:FRANCISCA
Last Name:BENITEZ-SERNA
Suffix:
Gender:F
Credentials:16413 RAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W MORRISON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-6124
Mailing Address - Country:US
Mailing Address - Phone:805-347-3338
Mailing Address - Fax:866-729-9741
Practice Address - Street 1:401 W MORRISON AVE STE B
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-6124
Practice Address - Country:US
Practice Address - Phone:805-347-3338
Practice Address - Fax:866-729-9741
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16413-RAC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)