NPIMap

Individual provider Active NPI

Tamika Henry, M.D.

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1063499283
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A73743 Issued in CA
Practice address
331 Arden Ave
Suite 101
Glendale, CA 91203-4059
Phone
(818) 967-0789
NPI assigned
Dec 29, 2005
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A73743 CA Primary

Addresses

Primary practice location

331 Arden Ave
Suite 101
Glendale, CA 91203-4059

Mailing address

331 Arden Ave
Ste 101
Glendale, CA 91203-4059
Phone (818) 967-0789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040308001332 CA Practitioner - Family PracticePractitioner - Internal Medicine 9436047701 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

331 Arden Ave
Suite 101
Glendale, CA 91203-4023
Phone (323) 496-0134

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A73743CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tamika Henry MD Inc Family Medicine CurrentSince Jan 7, 2025 Accepting new patients
Lakeside Medical Organization, a Medical Group Inc. Family Medicine CurrentSince Mar 17, 2010 Accepting new patients
Max Franklin Lebow, a Medical Corporation Past Accepting new patients
Alliance for Wellness, Inc. General Practice PastSince Jan 7, 2025 Accepting new patients
California Care Level Management Direct Medical Group, Inc General Practice PastSince Jun 26, 2006 Accepting new patients
Centinela Freeman Emergency Medical Associates Past Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

2355 23rd St
Eureka, CA 95501
Phone (747) 998-0387

1500 S Central Ave
Ste 200
Glendale, CA 91204
Phone (818) 242-8916

331 Arden Ave
Ste 101
Glendale, CA 91203
Phone (213) 761-4304

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

Interoperability endpoints

  • Direct secure messaging: tamika.henry.p1@direct.lakeside.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rockport Healthcare ServicesFortuna, CA, CCN 056361 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1063499283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 ARDEN AVE",
            "address_2": "STE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034059",
            "telephone_number": "818-967-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 ARDEN AVE",
            "address_2": "SUITE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034059",
            "telephone_number": "818-967-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "TAMIKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A73743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.