Bennett Agubata
Rehabilitation Practitioner in Riverside, CA. Individual provider (NPI-1).
NPI number1336861038
StatusActive
Last updated in NPPESOct 17, 2026
Details
- NPI
- 1336861038
- Entity type
- Individual (NPI-1)
- Name
- Bennett Agubata
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 19, 2022
- Certification date
- Oct 17, 2026
- Last updated
- Oct 17, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | CA | Yes |
Practice location
5425 Sierra Vista AveRiverside, CA 92505-3113
Phone 951-299-7545
Mailing address
5425 Sierra Vista AveRiverside, CA 92505-3113
Phone 951-299-7545
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