| Doctor Name: | MARY J. JODY BENSON |
| NPI Number: | 1013196112 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 234315 |
| Business Practice Address: | 351 Corrida Dr San Luis Obispo, CA - 934015524 |
| Business Phone Number: | 8055460313 |
| Business Fax Number: | 8057829107 |
| Mailing Address: | 351 Corrida Dr, SAN LUIS OBISPO |
| State: | CA |
| Postal Code: | 934015524 |
| Phone Number: | 8055460313 |
| Fax Number: | 8057829107 |
| NPI Enumeration Date: | 10/25/2007 |
| NPI Last Update Date: | 10/25/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 234315 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |