Most Relevant Information
Provider Data
| NPI Number: | 1003496522 |
| Provider Name: | AUSTIN J BENHAM |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/09/2021 |
| Last Updated: | 04/09/2021 |
Provider Practice Location
11650 IBERIA PL STE 130
SAN DIEGO
CA
921282431
Practice Location Phone/Fax
| Phone: | 8582645858 |
| Fax: | 8586496012 |
Provider Mailing Location
8855 ROBIN HOOD LN
LA JOLLA
CA
920372138
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |