Marian Henderson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

751795 Issued in CA

Practice address

4565 Ruffner St Ste 210
San Diego, CA 92111-2259

Phone

(858) 779-1397

NPI assigned

Jun 24, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308873600000",
    "number": "1295021566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 IMPERIAL AVE APT 332",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017824",
            "telephone_number": "619-269-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 RUFFNER ST STE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921112259",
            "telephone_number": "858-779-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARIAN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2011-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "751795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmin Henderson
• Joseph Alexander Henderson, LVN
• Keith Christopher Henderson, DDS
• Kelly Lynn Henderson, RN
• Leon Henderson
• Megan Henderson, PHARMD
• Nathaniel Amos Lee Henderson
• Patrick Ryan Henderson, MD
• Philip Lee Henderson
• Riley Henderson

• Registered Nurse in San Diego, CA
• Providers in San Diego, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; 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.