Individual provider Active NPI

Roy Edward Henderson, M.A.

  • Marriage & Family Therapist
  • Fair Oaks, CA
National Provider Identifier
1730102484
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC27845 Issued in CA
Practice address
7844 Madison Avenue
Suite 105
Fair Oaks, CA 95628-3595
Phone
(916) 962-7101
Fax
(916) 962-7102
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC27845 CA Primary

Addresses

Primary practice location

7844 Madison Avenue
Suite 105
Fair Oaks, CA 95628-3595

Mailing address

7844 Madison Avenue
Suite 105
Fair Oaks, CA 95628-3595
Phone (916) 962-7101

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC27845CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730102484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7844 MADISON AVENUE",
            "address_2": "SUITE 105",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283595",
            "telephone_number": "916-962-7101",
            "fax_number": "916-962-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7844 MADISON AVENUE",
            "address_2": "SUITE 105",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283595",
            "telephone_number": "916-962-7101",
            "fax_number": "916-962-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ROY",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC27845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • 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.