Vincente Salvador Hendricks, NONE

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

713 W Commonwealth Ave
Fullerton, CA 92832-1612

Phone

(714) 879-4274

NPI assigned

Jan 30, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1643500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643500800000",
    "number": "1255084331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20707 ANZA AVE APT 291",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905032921",
            "telephone_number": "361-759-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 W COMMONWEALTH AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928321612",
            "telephone_number": "714-879-4274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "VINCENTE",
        "middle_name": "SALVADOR",
        "name_prefix": "Mr.",
        "credential": "NONE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-30",
        "last_updated": "2022-01-30",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://efesi.codemetro.com/default.aspx?Site=Mobile",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "application",
            "address_1": "713 W Commonwealth Ave",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928321612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aaliyah Simone Henderson
• Donald W Henderson, MD
• George Alexander Henderson IV
• Janeen D Henderson, CNP
• Beverly Hendricks, COTA/C
• Mark Hennig, DDS
• Adriana Henriquez
• Henry Kaw MD Inc
• Jason A Henry
• Rebecca Henry

• Behavior Analyst in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2022; 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.