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Mr. Benjo Tan
Psychiatric/Mental Health Nurse Practitioner in Santa Ana, California
NPI 1841966249

Benjo Tan is a Psychiatric/Mental Health Nurse Practitioner based in Walnut, CA and is specialized in Psychiatric/Mental Health. Benjo Tan practices in Santa Ana, CA. The NPI Number for Benjo Tan is 1841966249 and holds a License No. 95017880 (California).

The current practice location address for Benjo Tan is 520 N Main St Ste 220, Santa Ana, CA and can be reached out via phone at 714-543-5609.

Location: 520 N Main St Ste 220, Santa Ana, CA, 91789-2344
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1841966249
Provider Name
Benjo Tan
Credential
Provider Entity Type
Individual
Gender
Male
Address
520 N Main St Ste 220, Santa Ana, CA, 91789-2344
Phone Number
714-543-5609
Fax Number
Provider Enumeration Date
08/17/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
95017880 01 CA NURSE PRACTITIONER LICENSE
institution
Provider Business Practice Location Address Details
Address
520 N Main St Ste 220
City
Santa Ana
State
California
Zip
92701-4623
Phone Number
714-543-5609
Fax Number
person
Provider Business Mailing Address Details
Address
520 N Main St Ste 220
City
Santa Ana
State
California
Zip
92701-4623
Phone Number
714-543-5609
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
95017880 (California)
Definition
Definition to come...
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