Alexander Glenn Henderson

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

3050 Beacon Blvd Ste 103
West Sacramento, CA 95691-3467

Phone

(916) 462-3100

NPI assigned

May 19, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1306583380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 BEACON BLVD STE 103",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913467",
            "telephone_number": "916-462-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 BEACON BLVD STE 103",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913467",
            "telephone_number": "916-462-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Empire St",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945335702",
            "country_code": "US",
            "telephone_number": "707-425-5744",
            "fax_number": "707-425-5162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ALEXANDER",
        "middle_name": "GLENN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "victor.org",
            "affiliation": "N",
            "address_1": "3050 Beacon Blvd Ste 103",
            "city": "West Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956913467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristen Hatten, PHD
• Amber Hawkins
• Elizabeth Haywood
• Shaughn Mitchell Head, MD
• Healing Pathways Medical Clinic, Inc.
• Ruth L Henderson
• Michael Henning
• Rhonda Hensley
• Francisca Heredia
• Arthur Hernandez, F.N.P.

• All providers in West Sacramento, CA
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.