Active NPI
Kerry James Henderson
- Counselor
- El Centro, CA
National Provider Identifier
1376747360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1295 State Street
El Centro, CA 92243 - Phone
- (760) 482-4000
- NPI assigned
- Jun 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1295 State Street
El Centro, CA 92243
Mailing address
670 South Third Street
Brawley, CA 92227
Phone (760) 351-2178
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233532800000",
"number": "1376747360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 SOUTH THIRD STREET",
"city": "BRAWLEY",
"state": "CA",
"postal_code": "92227",
"telephone_number": "760-351-2178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1295 STATE STREET",
"city": "EL CENTRO",
"state": "CA",
"postal_code": "92243",
"telephone_number": "760-482-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "KERRY",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-13",
"last_updated": "2009-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Centro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.