Individual provider Active NPI

Katherine Henson, NP

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1083335525
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95135212 Issued in CA
Practice address
6280 Jackson Dr Ste 8
San Diego, CA 92119-3436
Phone
(619) 752-0011
NPI assigned
Sep 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95135212 CA Primary

Addresses

Primary practice location

6280 Jackson Dr Ste 8
San Diego, CA 92119-3436

Mailing address

6280 Jackson Dr Ste 8
San Diego, CA 92119-3436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122003478 CA Practitioner - Nurse Practitioner 1153799135 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Del Sur HealthcareGroup PAC ID 1850827395, 61 clinicians

Practice addresses (Care Compare)

436 S Magnolia Ave
Suite 101
El Cajon, CA 92020-5219
Phone (760) 978-8596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95135212CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Myndfull Care California PC CurrentSince Feb 6, 2024 Accepting new patients
Del Sur Healthcare CurrentSince Nov 1, 2024 Accepting new patients
Myndfull Care Management California PC CurrentSince Dec 1, 2022 Accepting new patients
Geri Connection CurrentSince Dec 2, 2022 Accepting new patients
Bay View Health Solutions CurrentSince Mar 3, 2025 Accepting new patients

Locations

1999 S Bascom Ave
Ste 700
Campbell, CA 95008
Phone (760) 978-8596

436 S Magnolia Ave
Ste 101
El Cajon, CA 92020
Phone (760) 978-8596

15644 Pomerado Rd
Ste 202
Poway, CA 92064
Phone (619) 320-8090

8445 Camino Santa Fe
Ste 215
San Diego, CA 92121
Phone (619) 541-3246

9436 W Lake Mead Blvd
Ste 5
Las Vegas, NV 89134
Phone (702) 328-7648

Interoperability endpoints

  • Direct secure messaging: katherine.henson@1060541286121476.direct.elationemr.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1083335525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6280 JACKSON DR STE 8",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921193436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6280 JACKSON DR STE 8",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921193436",
            "telephone_number": "619-752-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "KATHERINE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95135212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.