Individual provider Active NPI

Anna Celeste Hendricks, MSW/MPH

  • Social Worker
  • Ukiah, CA
National Provider Identifier
1255921052
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
333 Laws Ave
Ukiah, CA 95482-6540
Phone
(707) 468-1010
NPI assigned
Jan 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

333 Laws Ave
Ukiah, CA 95482-6540

Mailing address

PO Box 255
Bayside, CA 95524-0255

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210511002729 CA Practitioner - Clinical Social Worker 8921417593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Madrone St
Willits, CA 95490-4225
Phone (707) 459-6801

333 Laws Ave
Ukiah, CA 95482-6540
Phone (458) 292-2167

45 Hazel St
Willits, CA 95490-4222
Phone (707) 456-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100418CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mendocino Community Health Clinic, Inc. CurrentSince Mar 8, 2021 Accepting new patients
Mendocino Community Health Clinic, Inc. CurrentSince Mar 8, 2021 Accepting new patients

Locations

333 Laws Ave
Ukiah, CA 95482
Phone (707) 463-1113

Organizations & group practices 2

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": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1255921052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255",
            "city": "BAYSIDE",
            "state": "CA",
            "postal_code": "955240255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LAWS AVE",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954826540",
            "telephone_number": "707-468-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "ANNA",
        "middle_name": "CELESTE",
        "credential": "MSW/MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.