Provider Demographics
NPI:1134365943
Name:BENT, ALISHA CHRISTINE (PHD)
Entity type:Individual
Prefix:DR
First Name:ALISHA
Middle Name:CHRISTINE
Last Name:BENT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ALISHA
Other - Middle Name:CHRISTINE
Other - Last Name:LEDLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11401 BLOOMFIELD AVENUE
Mailing Address - Street 2:METROPOLITAN STATE HOSPITAL
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650
Mailing Address - Country:US
Mailing Address - Phone:562-651-3268
Mailing Address - Fax:
Practice Address - Street 1:11401 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2015
Practice Address - Country:US
Practice Address - Phone:562-651-3268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22340103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical