Benny Ray Martin, Ph.D.
Psychologist, Clinical in Atascadero, CA. Individual provider (NPI-1).
NPI number1124150180
StatusActive
Last updated in NPPESNov 8, 2023
Details
- NPI
- 1124150180
- Entity type
- Individual (NPI-1)
- Name
- Mr. Benny Ray Martin
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 12, 2007
- Certification date
- Nov 8, 2023
- Last updated
- Nov 8, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PY00003320 | WA | Yes |
| 103TC0700X | Psychologist, Clinical | PSY22824 | CA |
Practice location
10333 El Camino RealAtascadero, CA 93422-5808
Phone 805-468-2000 · Fax 805-468-6011
Mailing address
10333 El Camino RealAtascadero, CA 93422-5808
Other practice locations
1229 Higuera St
San Luis Obispo, CA 93401-3169
San Luis Obispo, CA 93401-3169
Phone 805-457-6123 · Fax 866-496-9881
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