Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ROBERT BENAVIDES JR PROFESSIONAL PSYCHOLOGY CORPORATION
NPI 1386674059
Psychologist in Santa Rosa, CA

Active since July 05, 2006
2455 BENNETT VALLEY RD, #210 C, SANTA ROSA, CA 95404(707) 542-2081 Get Directions Write a Review

NPPES record last updated: November 4, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 4, 2026, Aug 22, 2020 (2 updates tracked since 2020).

About Robert Benavides Jr Professional Psychology Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROBERT BENAVIDES JR PROFESSIONAL PSYCHOLOGY CORPORATION (NPI 1386674059) is a healthcare organization registered as a psychologist in Santa Rosa, California and active in the NPI registry since July 2006. The organization lists Robert Benavides, Owner, as its authorized official.

NPPES Registry Identity

NPI1386674059
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameROBERT BENAVIDES JR PROFESSIONAL PSYCHOLOGY CORPORATION
Location Address2455 BENNETT VALLEY RD, #210 CSanta Rosa, CA 95404-5663
Mailing Address2455 Bennett Valley Rd Ste C210Santa Rosa, CA 95404-5671 · (707) 542-2081 · Fax (707) 542-2082
Organization SubpartNo
Authorized OfficialRobert BenavidesOwner · (707) 542-2081
Enumeration DateJuly 5, 2006
Last NPPES UpdateNovember 4, 20262 updates tracked since enumeration
NPPES CertifiedNovember 4, 2026
✔ NPI 1386674059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in CA · PSY11363
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
2455 BENNETT VALLEY RD, Santa Rosa, CA 95404

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Robert Benavides Jr Professional Psychology Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20080131000251Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Robert Benavides Jr Professional Psychology Corporation, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Psychologist
NPI 1487638714
2455 BENNETT VALLEY RD SUITE 210 C
Santa Rosa, CA 95404
(707) 542-2081
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Robert Benavides Jr Professional Psychology Corporation's NPI number?

The NPI number for Robert Benavides Jr Professional Psychology Corporation is 1386674059. It was assigned to this organization in the NPPES registry on July 5, 2006.

Where is Robert Benavides Jr Professional Psychology Corporation located?

Robert Benavides Jr Professional Psychology Corporation is located at 2455 Bennett Valley Rd #210 C, Santa Rosa, CA 95404. The listed phone number is (707) 542-2081.

What is Robert Benavides Jr Professional Psychology Corporation's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Robert Benavides Jr Professional Psychology Corporation enrolled in Medicare?

Yes. Robert Benavides Jr Professional Psychology Corporation is registered in the Medicare PECOS enrollment system.

When is Robert Benavides Jr Professional Psychology Corporation's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Robert Benavides Jr Professional Psychology Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Robert Benavides Jr Professional Psychology Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Robert Benavides Jr Professional Psychology Corporation was last updated on November 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.