DR. ROBERT BENAVIDES JR. ED.D.
NPI 1487638714
Psychologist in Santa Rosa, CA

Active since November 30, 2005PECOS EnrolledAccepts Medicare Assignment
2455 BENNETT VALLEY RD, SUITE 210 C, SANTA ROSA, CA 95404(707) 542-2081(707) 542-2082 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Robert Benavides Jr. Ed.d. NPPES

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

DR. ROBERT BENAVIDES JR. ED.D. (NPI 1487638714) is an individual psychologist in Santa Rosa, California, licensed in California (PSY 11363) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1986).

NPPES Registry Identity

NPI1487638714
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. ROBERT BENAVIDES JR.Credential: ED.D.
Location Address2455 BENNETT VALLEY RD, SUITE 210 CSanta Rosa, CA 95404-5663
Mailing Address2455 Bennett Valley Rd, Suite 210 CSanta Rosa, CA 95404-5663 · (707) 542-2081 · Fax (707) 542-2082
Fax(707) 542-2082
Sole ProprietorNo
Medical School CMSOtherGraduated 1986
Enumeration DateNovember 30, 2005
Last NPPES UpdateJuly 9, 2007
NPI 1487638714 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 · PSY 11363
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

Other Identifiers 2

Medicare ID-Type Unspecified0PL113630CA
Medicare UPIN4269907CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Robert Benavides Jr. Ed.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779665682
PECOS Enrollment IDI20080131000246
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
2455 BENNETT VALLEY RD, SUITE 208B
SANTA ROSA, CA 95404
Social Worker (Clinical)
2455 BENNETT VALLEY RD, SUITE 208B
SANTA ROSA, CA 95404
Psychologist
2455 BENNETT VALLEY RD
SANTA ROSA, CA 95404
Psychologist (Clinical)
2455 BENNETT VALLEY RD, SUITE 208B
SANTA ROSA, CA 95404
Anesthesiology
2455 BENNETT VALLEY RD
SANTA ROSA, CA 95404
Psychologist
2455 BENNETT VALLEY RD, #210 C
SANTA ROSA, CA 95404
Psychologist (Clinical Child & Adolescent)
2455 BENNETT VALLEY RD, SUITE B208
SANTA ROSA, CA 95404
Psychologist (Clinical)
2455 BENNETT VALLEY RD, WATERFALL TOWERS SUITE B-208
SANTA ROSA, CA 95404

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.'s NPI number?

The NPI number for Robert Benavides Jr. is 1487638714. It was assigned to this individual provider in the NPPES registry on November 30, 2005.

Where is Robert Benavides Jr. located?

Robert Benavides Jr. practices at 2455 Bennett Valley Rd Suite 210 C, Santa Rosa, CA 95404. The listed phone number is (707) 542-2081.

What is Robert Benavides Jr.'s specialty?

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

Is Robert Benavides Jr. enrolled in Medicare?

Yes. Robert Benavides Jr. is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Robert Benavides Jr. was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.