Provider Demographics
NPI:1124909866
Name:BENSON, MARINA LYNN VEGA (AMFT)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:LYNN VEGA
Last Name:BENSON
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:LYNN
Other - Last Name:VEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT
Mailing Address - Street 1:PO BOX 3004
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-3004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1021 E WALNUT ST STE 208
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1453
Practice Address - Country:US
Practice Address - Phone:818-570-1636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA157828106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist