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Carissa Darlene Bennett, AUD
Specialist in Los Angeles, California
NPI 1104869551

Carissa Darlene Bennett is a Specialist based in Los Angeles, CA. Carissa Darlene Bennett practices in Los Angeles, CA and has the professional credentials of AUD. The NPI Number for Carissa Darlene Bennett is 1104869551 and holds a License No. AU759 (California).

The current practice location address for Carissa Darlene Bennett is 11645 Wilshire Blvd, Los Angeles, CA and can be reached out via phone at 310-477-5558 and via fax at 310-477-7281.

Location: 11645 Wilshire Blvd, Los Angeles, CA, 90025-1708
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104869551
Provider Name
Carissa Darlene Bennett
Credential
AUD
Provider Entity Type
Individual
Gender
Female
Address
11645 Wilshire Blvd, Los Angeles, CA, 90025-1708
Phone Number
310-477-5558
Fax Number
310-477-7281
Provider Enumeration Date
06/14/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AUD0007590 05 CA
institution
Provider Business Practice Location Address Details
Address
11645 Wilshire Blvd
City
Los Angeles
State
California
Zip
90025-1708
Phone Number
310-477-5558
Fax Number
310-477-7281
person
Provider Business Mailing Address Details
Address
11645 Wilshire Blvd
City
Los Angeles
State
California
Zip
90025-1708
Phone Number
310-477-5558
Fax Number
310-477-7281
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
AU759 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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