Active NPI
Elliot J. Henderson, PH.D
- Psychologist
- San Francisco, CA
National Provider Identifier
1043746282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY8809
- Practice address
- 909 Hyde Street
Suite 428
San Francisco, CA 94109 - Phone
- (415) 563-5566
- Fax
- (415) 563-5558
- NPI assigned
- May 9, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY8809 | CA | Primary |
Addresses
Primary practice location
909 Hyde Street
Suite 428
San Francisco, CA 94109
Mailing address
909 Hyde Street
Suite 428
San Francisco, CA 94109
Phone (415) 563-5566
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY8809 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494288000000",
"number": "1043746282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 HYDE STREET",
"address_2": "SUITE 428",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94109",
"telephone_number": "415-563-5566",
"fax_number": "415-563-5558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 HYDE STREET",
"address_2": "SUITE 428",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94109",
"telephone_number": "415-563-5566",
"fax_number": "415-563-5558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "ELLIOT",
"middle_name": "J.",
"name_prefix": "Mr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-09",
"last_updated": "2017-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY8809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.