Individual provider Active NPI

Jeffrey Tevin Hen, CRNA

  • Certified Registered Nurse Anesthetist
  • Stockton, CA
National Provider Identifier
1972173185
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95002301 Issued in CA
Practice address
4009 Kenny Dr
Stockton, CA 95212-3458
Phone
(209) 616-2310
NPI assigned
Jun 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 95159147 CA
Certified Registered Nurse Anesthetist 367500000X 95002301 CA Primary

Addresses

Primary practice location

4009 Kenny Dr
Stockton, CA 95212-3458

Mailing address

4009 Kenny Dr
Stockton, CA 95212-3458
Phone (209) 616-2310

Other practice location 1

460 Plumas Blvd Ste 202
Yuba City, CA 95991-5005
Phone (530) 749-5700

Other practice location 2

2702 Low Ct
Fairfield, CA 94534-9771
Phone (916) 733-8222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404003198 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284072521 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Regional Anesthesia Associates IncGroup PAC ID 3870964323, 143 clinicians

Practice addresses (Care Compare)

1441 Florida Ave
Modesto, CA 95350-4404
Phone (209) 578-1211

Hospital & facility affiliations

  • Doctors Medical Center Hospital, Modesto, CA, CCN 050464
  • Emanuel Medical Center Hospital, Turlock, CA, CCN 050179
  • Dameron Hospital Hospital, Stockton, CA, CCN 050122
  • Doctors Hospital of Manteca Hospital, Manteca, CA, CCN 050118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95159147CAMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Regional Anesthesia Associates Inc CurrentSince Sep 5, 2024 Accepting new patients
Green Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Jun 25, 2024 Accepting new patients
Anesthesia Services of San Joaquin, P.C. CurrentSince Jun 30, 2025 Accepting new patients
Advanced Anesthesia Incorporated Nurse Anesthetist, Certified Registered PastSince Dec 10, 2023 Accepting new patients

Locations

3123 Professional Dr
Ste 100A
Auburn, CA 95603
Phone (530) 888-8899

3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000

2700 Low Ct
Fl 2
Fairfield, CA 94534
Phone (707) 432-2700

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

9479 N Fort Washington Rd
Ste 103
Fresno, CA 93730
Phone (559) 289-4574

223 Clinton Rd
Ste 204
Jackson, CA 95642
Phone (209) 223-5938

1660 W 3rd St
Los Angeles, CA 90017
Phone (213) 201-0850

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

2900 Eureka Way
Redding, CA 96001
Phone (530) 225-8700

1238 West St
Redding, CA 96001
Phone (530) 241-5499

4 Medical Plaza Dr
Ste 210
Roseville, CA 95661
Phone (916) 773-8780

1420 E Roseville Pkwy
Ste 100
Roseville, CA 95661
Phone (916) 677-2488

7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000

2388 N California St
Stockton, CA 95204
Phone (209) 465-2711

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

Organizations & group practices 9

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1972173185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 KENNY DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952123458",
            "telephone_number": "209-616-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 KENNY DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952123458",
            "telephone_number": "209-616-2310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Plumas Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Yuba City",
            "state": "CA",
            "postal_code": "959915005",
            "country_code": "US",
            "telephone_number": "530-749-5700",
            "fax_number": "530-749-5720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2702 Low Ct",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945349771",
            "country_code": "US",
            "telephone_number": "916-733-8222",
            "fax_number": "916-733-8224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEN",
        "first_name": "JEFFREY",
        "middle_name": "TEVIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-29",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95159147",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.