Provider Demographics
NPI:1255527933
Name:BENEDICTO, MARIA PRECIOSA ANCHETA (LVN)
Entity type:Individual
Prefix:MRS
First Name:MARIA PRECIOSA
Middle Name:ANCHETA
Last Name:BENEDICTO
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 E MUNCIE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0461
Mailing Address - Country:US
Mailing Address - Phone:559-930-4071
Mailing Address - Fax:
Practice Address - Street 1:2330 E MUNCIE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0461
Practice Address - Country:US
Practice Address - Phone:559-930-4071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN204061164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse