Provider Demographics
NPI:1841828563
Name:BENEFIELD, ELINOR ANNE
Entity type:Individual
Prefix:
First Name:ELINOR
Middle Name:ANNE
Last Name:BENEFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 HENRY AVE
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2131
Mailing Address - Country:US
Mailing Address - Phone:301-674-2232
Mailing Address - Fax:
Practice Address - Street 1:1918 HENRY AVE
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2131
Practice Address - Country:US
Practice Address - Phone:301-674-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-29
Last Update Date:2020-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAY8697091OtherCALIFORNIA