Individual provider Active NPI

Brent Alexander Henrikson, M.S.

  • Marriage & Family Therapist
  • Citrus Heights, CA
National Provider Identifier
1174830897
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF64110 Issued in CA
Practice address
8421 Auburn Blvd
BLDG. #3
Citrus Heights, CA 95610-0359
Phone
(916) 722-6100
Fax
(916) 722-9229
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X IMF64110 CA Primary

Addresses

Primary practice location

8421 Auburn Blvd
BLDG. #3
Citrus Heights, CA 95610-0359

Mailing address

8421 Auburn Blvd
BLDG. #3
Citrus Heights, CA 95610-0359
Phone (916) 722-6100

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
Master of Science

State licenses

LicenseStateTypeSpecialty
IMF64110CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1174830897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8421 AUBURN BLVD",
            "address_2": "BLDG. #3",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956100359",
            "telephone_number": "916-722-6100",
            "fax_number": "916-722-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8421 AUBURN BLVD",
            "address_2": "BLDG. #3",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956100359",
            "telephone_number": "916-722-6100",
            "fax_number": "916-722-9229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIKSON",
        "first_name": "BRENT",
        "middle_name": "ALEXANDER",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF64110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.