Provider Demographics
NPI:1538589569
Name:UHATAFE, BENJAMIN FRANKLIN
Entity type:Individual
Prefix:MR
First Name:BENJAMIN FRANKLIN
Middle Name:
Last Name:UHATAFE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 UDONA LANE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CALIFORNIA
Mailing Address - Zip Code:95351
Mailing Address - Country:UM
Mailing Address - Phone:606-283-7954
Mailing Address - Fax:
Practice Address - Street 1:1904 RICHLAND AVE
Practice Address - Street 2:
Practice Address - City:CERES
Practice Address - State:CA
Practice Address - Zip Code:95351
Practice Address - Country:US
Practice Address - Phone:209-300-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst