Provider Demographics
NPI:1205964384
Name:BENNETT, RHONDA KAY (MS, LMFT)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:KAY
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:KAY
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81880 DOCTOR CARREON BLVD STE B207
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5585
Mailing Address - Country:US
Mailing Address - Phone:323-696-4640
Mailing Address - Fax:
Practice Address - Street 1:81880 DOCTOR CARREON BLVD STE B207
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5585
Practice Address - Country:US
Practice Address - Phone:323-696-4640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 42430106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist