Henderson Surgical Physician Assistant

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

51407 Issued in CA

Legal business name

HENDERSON SURGICAL PHYSICIAN ASSISTANT

Practice address

4445 Magnolia Ave
Riverside, CA 92501-4135

Phone

(951) 443-9606

NPI assigned

Aug 7, 2017

Organization subpart

No

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

Authorized official

Name

Sofia Henderson, PHYSCIAN ASSISTANT

Title

President

Phone

(951) 443-9606

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502064000000",
    "number": "1982129342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 FREDERICK ST # I5215",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535216",
            "telephone_number": "951-443-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135",
            "telephone_number": "951-443-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON SURGICAL PHYSICIAN ASSISTANT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-07",
        "last_updated": "2017-08-07",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "SOFIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-443-9606",
        "authorized_official_credential": "PHYSCIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "51407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydni Danielle Helm
• Micheline Helou, FNP-C
• Helping Hearts Hulen, LLC
• Muhammad Eyad Helwany, DO
• Heena Hemani
• Amber E Henderson, MSW
• Breanna Henderson
• Genevieve Henderson
• Miya Denise Henderson
• Ronald Henderson

• Surgical Physician Assistant in Riverside, CA
• Providers in Riverside, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; 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.