Kiera A Henderson

Primary specialty

Meals ProviderTaxonomy code 174200000X

Practice address

3025 N Golden Ave Apt 216
San Bernardino, CA 92404-2730

Phone

(909) 269-3506

NPI assigned

Jul 24, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1831879907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 N GOLDEN AVE APT 216",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924042730",
            "telephone_number": "909-269-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 N GOLDEN AVE APT 216",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924042730",
            "telephone_number": "909-269-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KIERA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Helsper, MSW
• Hemmat & Roboubi DDS Inc.
• Hemway Health LLC
• Darlene Henderson
• Jasmine Henderson
• Letitia Henderson
• Matthew Lee Henderson
• Raquel Marie Henderson, PA-C
• Shakoya Henderson
• Shatzie V Henderson

• Meals Provider in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Meals Provider in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.