Brendan Bennett
Student in an Organized Health Care Education/Training Program in Tustin, CA. Individual provider (NPI-1).
NPI number1073965554
StatusActive
Last updated in NPPESMay 1, 2023
Details
- NPI
- 1073965554
- Entity type
- Individual (NPI-1)
- Name
- Brendan Bennett
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 7, 2016
- Certification date
- May 1, 2023
- Last updated
- May 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – |
Practice location
13271 Charloma DrTustin, CA 92780-3809
Phone 713-369-9532
Mailing address
1586 Border Ave Unit CCorona, CA 92882-4717
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All 16 Student in an Organized Health Care Education/Training Program providers in Tustin · All 3,076 providers in Tustin
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