Mary H. Henderson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN 358569 Issued in CA

Practice address

355 Tuolumne St
Vallejo, CA 94590-5700

Phone

(707) 553-5055

Fax

(707) 421-5056

NPI assigned

Jun 1, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1992066377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 TUOLUMNE ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945905700",
            "telephone_number": "707-553-5055",
            "fax_number": "707-421-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 TUOLUMNE ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945905700",
            "telephone_number": "707-553-5055",
            "fax_number": "707-421-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARY",
        "middle_name": "H.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN 358569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helios Healthcare, LLC (Vallejo Care Center)
• Amanda Jane Helle, DO
• Jessica Henderson
• Kelby Unique Henderson
• Kristen Henderson, OTR/L
• Stacey Edwina Hendricks
• Tami Hendriksz, D.O.
• Sean Patrick Hennessey, MD
• Estefania M Henriquez
• Lakeisha Henry

• Registered Nurse in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; 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.