Sandra Lee Hendrickson, GERIATRIC NURSE PRAC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2242 Issued in CA

Practice address

1011 Cass St Ste 107
Monterey, CA 93940-4542

Phone

(831) 324-0416

NPI assigned

Apr 30, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1083931968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 FOREST RIDGE RD",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939404101",
            "telephone_number": "831-236-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 CASS ST STE 107",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939404542",
            "telephone_number": "831-324-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "GERIATRIC NURSE PRAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "2242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CA147502",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Walter Hell, M.D.
• Tara Heller-Berlin
• Gay Heller
• Lynn Denice Hendrick, PHARMD
• Michael David Hendrick, MD
• Amanda Henrie
• Vanessa Carmen Henry
• Camille Katrina Henson
• Marcy Henzel
• Catherine Herbert

• Gerontology Nurse Practitioner in Monterey, CA
• Providers in Monterey, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; 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.