Provider Demographics
NPI:1811631468
Name:BENCOHEN, SHARON TALEI (LAC)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:TALEI
Last Name:BENCOHEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:TALEI
Other - Last Name:BENCOHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:2918 TIFFANY CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1721
Mailing Address - Country:US
Mailing Address - Phone:310-780-5530
Mailing Address - Fax:
Practice Address - Street 1:1335 N LA BREA AVE STE 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-7565
Practice Address - Country:US
Practice Address - Phone:310-948-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA5642171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty