Individual provider Active NPI

Dionne Lashon Henderson, PA-C

  • Medical Physician Assistant
  • Carson, CA
National Provider Identifier
1972511319
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA18290 Issued in CA
Practice address
20920 Chico St
Carson, CA 90746-3603
Phone
(424) 333-9151
Fax
(833) 973-3630
NPI assigned
Aug 3, 2006
Last updated
Aug 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA18290 CA Primary

Addresses

Primary practice location

20920 Chico St
Carson, CA 90746-3603

Mailing address

2881 Park Vista CT
Fullerton, CA 92835-2903
Phone (562) 746-3950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630003895 CA Practitioner - Physician Assistant 6507379898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18290CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cranford L. Scott, M.D., Inc. Past Accepting new patients
Icm Medical Group, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1972511319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2881 PARK VISTA CT",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352903",
            "telephone_number": "562-746-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20920 CHICO ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463603",
            "telephone_number": "424-333-9151",
            "fax_number": "833-973-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DIONNE",
        "middle_name": "LASHON",
        "name_prefix": "Prof.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

Verify at the official NPI Registry.