Provider Demographics
NPI:1881499416
Name:BENITEZ, ANA MARCELA (FNP-C)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:MARCELA
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:MARCELA
Other - Last Name:PLASENCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 OAK PARK BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:PISMO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93449-3409
Mailing Address - Country:US
Mailing Address - Phone:805-888-4744
Mailing Address - Fax:
Practice Address - Street 1:901 OAK PARK BLVD STE 103
Practice Address - Street 2:
Practice Address - City:PISMO BEACH
Practice Address - State:CA
Practice Address - Zip Code:93449-3409
Practice Address - Country:US
Practice Address - Phone:805-888-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95032517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily