Jennifer Lynn Hendricks, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

72718 Issued in CA

Practice address

9812 Mercy Rd Apt 3
San Diego, CA 92129-5041

Phone

(513) 504-8796

NPI assigned

May 12, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Jennifer Lynn Humeniuk Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1235457581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10181 SCRIPPS GATEWAY CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921315152",
            "telephone_number": "513-504-8796",
            "fax_number": "844-713-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9812 MERCY RD APT 3",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921295041",
            "telephone_number": "513-504-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "10131",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "72718",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OH",
            "license": "0332773",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF PHARMACY",
            "identifier": "10131",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF PHARMACY",
            "identifier": "72718",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HUMENIUK",
            "middle_name": "LYNN",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Theresa Ann Henderson, LCSW
• Trevor Howard Henderson, MD
• Sarah Rachel Hendon
• Daniel Brian Hendrey, M.D.
• James Hendricks, D.O.
• Korey Solomon Hendricks, MA, LPCC
• Mark D. Hendricks, M.D.
• Michael Ryan Hendricks II
• Michael Ryan Hendricks, IDC
• Myles Hendricks

• Pharmacist in San Diego, CA
• Providers in San Diego, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.