Mellissa Henry, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

14009 Issued in CA

Practice address

3742 Green Ave Apt 3
Los Alamitos, CA 90720-3256

Phone

(909) 758-6040

NPI assigned

Aug 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1566000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566000000000",
    "number": "1881240547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3742 GREEN AVE APT 3",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203256",
            "telephone_number": "909-758-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3742 GREEN AVE APT 3",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203256",
            "telephone_number": "909-758-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MELLISSA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-17",
        "last_updated": "2019-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "520316",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "14009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Heeren, PPS
• Helen Mahoney MD Inc
• Nancy Helms, PAC
• Kathryn Elizabeth Henning, M.S., R.D.
• Kirsten Henriquez
• Ward James Henry III, D.C.
• Rhisie Hentges, LMFT
• Michael Hermansen, PA-C
• Kenya Hernandez
• Yasmin Herring, MD

• Family Nurse Practitioner in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2019; 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.