Diane Joyce Henderson, M.D.

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

G22020 Issued in CA

Practice address

2300 S Flower St
Suite 300
Los Angeles, CA 90007-2660

Phone

(213) 742-1433

Fax

(213) 742-1496

NPI assigned

Sep 6, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700989001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 S FLOWER ST",
            "address_2": "SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072677",
            "telephone_number": "213-742-1433",
            "fax_number": "213-742-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S FLOWER ST",
            "address_2": "SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072660",
            "telephone_number": "213-742-1433",
            "fax_number": "213-742-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DIANE",
        "middle_name": "JOYCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "G22020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL NUMBER",
            "identifier": "00G220200",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCS PROVIDER NUMBER",
            "identifier": "CGP168503",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittney Henderson
• Carletta Y Henderson
• Cressida Henderson, MFT
• Darius Khadar Henderson
• Davilee H Henderson
• Gena Beth Henderson, APRN, WHNP-BC, IBCLC
• Heather Rose Henderson
• Helen Henderson, RDA
• Hillary Henderson, APCC
• Holly Henderson

• Developmental - Behavioral Pediatrics Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Developmental - Behavioral Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.