Active NPI
Theresa Michele Henry, P.A-C
- Physician Assistant
- Santa Ana, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA14684
- Practice address
- 210 N Tustin Ave
Santa Ana, CA 92705-3807 - Phone
- (888) 959-5192
- NPI assigned
- Aug 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA14684 | CA | Primary |
Addresses
Primary practice location
210 N Tustin Ave
Santa Ana, CA 92705-3807
Mailing address
210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (888) 959-5192
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14684 | CA | MD | General Care Certified Respiratory Therapist |
| PA14684 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Current | Accepting new patients | |
| Cep America - California | Current | Accepting new patients |
Locations
2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777
24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500
350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500
4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mobile Mammography Clinic/Center
- Santa Ana, CA
- NPI 1619772696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709510400000",
"number": "1942316757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 N TUSTIN AVE",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927053807",
"telephone_number": "888-959-5192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N TUSTIN AVE",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927053807",
"telephone_number": "888-959-5192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "THERESA",
"middle_name": "MICHELE",
"credential": "P.A-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA14684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.