Kristina Koppanyi Henderson

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

E075690 Issued in CA

Practice address

251 Llewellyn Ave
Campbell, CA 95008-1940

Phone

(669) 308-7367

NPI assigned

Aug 30, 2023

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1407631153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 LLEWELLYN AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950081940",
            "telephone_number": "669-308-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 LLEWELLYN AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950081940",
            "telephone_number": "669-308-7367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KRISTINA",
        "middle_name": "KOPPANYI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "E075690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Weina He
• Simon Kevin Heerdegen
• Heinz J. Klein, D.M.D. & Linda R. Kono, D.M.D., Inc.
• Denise Henderson, LMFT
• Janet M Henderson, MA
• Leidy Carolina Henry
• Diana Ruby Hernandez Barba
• Lidia Mariela Hernandez Lazaro
• Dasai Araceli Hernandez Loyola
• Valeria Hernandez Hernandez Romero

• Basic Emergency Medical Technician in Campbell, CA
• Providers in Campbell, CA by specialty
• Basic Emergency Medical Technician in California

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