Individual provider Active NPI

Ryan Henderson, MRI TECHNOLOGIST

  • Magnetic Resonance Imaging Radiologic Technologist
  • Laguna Woods, CA
National Provider Identifier
1003601139
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging Radiologic TechnologistTaxonomy code 2471M1202X
License
1128 Issued in CA
Practice address
24331 El Toro Rd
Laguna Woods, CA 92637-2752
Phone
(949) 586-3200
NPI assigned
Apr 10, 2025
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging Radiologic Technologist 2471M1202X 1128 CA Primary

Addresses

Primary practice location

24331 El Toro Rd
Laguna Woods, CA 92637-2752

Mailing address

24331 El Toro Rd
Laguna Woods, CA 92637-2752
Phone (949) 586-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1128CAMDKinesiotherapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1003601139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24331 EL TORO RD",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926372752",
            "telephone_number": "949-586-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24331 EL TORO RD",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926372752",
            "telephone_number": "949-586-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "RYAN",
        "credential": "MRI TECHNOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471M1202X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "CA",
            "license": "1128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Woods, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.