Active NPI
Karen Henriquez, OTC
- Other Technician
- Modesto, CA
National Provider Identifier
1043356827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 01-0161
- Practice address
- 609 E Orangeburg Ave
Modesto, CA 95350-5580 - Phone
- (209) 572-3224
- Fax
- (209) 572-4528
- NPI assigned
- Jan 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | 01-0161 | CA | Primary |
Addresses
Primary practice location
609 E Orangeburg Ave
Modesto, CA 95350-5580
Mailing address
609 E Orangeburg Ave
Modesto, CA 95350-5580
Phone (209) 572-3224
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
| License | State | Type | Specialty |
|---|---|---|---|
| 01-0161 | CA | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043356827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 E ORANGEBURG AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953505580",
"telephone_number": "209-572-3224",
"fax_number": "209-572-4528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 E ORANGEBURG AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953505580",
"telephone_number": "209-572-3224",
"fax_number": "209-572-4528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRIQUEZ",
"first_name": "KAREN",
"name_prefix": "Mrs.",
"credential": "OTC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "CA",
"license": "01-0161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.