Provider Demographics
NPI:1831223460
Name:BENVEGNU, CLAUDIA BENVEGNU JOHNSON (LAC, PHD)
Entity type:Individual
Prefix:
First Name:CLAUDIA BENVEGNU
Middle Name:JOHNSON
Last Name:BENVEGNU
Suffix:
Gender:F
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:JEAN
Other - Last Name:JOHNSON-BENVEGNU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC, PHD
Mailing Address - Street 1:51 RENATO CT
Mailing Address - Street 2:STE. E
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-4094
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:51 RENATO CT
Practice Address - Street 2:STE. E
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-4094
Practice Address - Country:US
Practice Address - Phone:650-369-0374
Practice Address - Fax:650-369-1349
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5315171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist