Michael Vahid Hendricks, R1540271223

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1540271223 Issued in CA

Practice address

2901 S H St
Bakersfield, CA 93304-5602

Phone

(661) 398-4303

NPI assigned

Jun 27, 2024

Sex

Male

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": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1558106971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 S H ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933045602",
            "telephone_number": "661-398-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 S H ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933045602",
            "telephone_number": "661-398-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "MICHAEL",
        "middle_name": "VAHID",
        "credential": "R1540271223",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1540271223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garyn Henderson
• Heidi Henderson
• Linda Reed Henderson, MD
• Lisa Ann Henderson
• Ronique Z Henderson
• Misty Jill Hendricks, D.D.S.
• Skyler Leona Hendricks
• Marshall Greg Hendrickson
• Carol J Hendrix, CAROL HENDRIX PH.D.
• Talyia Hendrix

• Addiction (Substance Use Disorder) Counselor in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.