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NPI Code Detail

MEDICARE: LAUREN HENDERSON

MEDICARE: LAUREN HENDERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1124561535
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN HENDERSON
Provider Business Mailing Address
First Line : 822 GEARY ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-7228
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 822 GEARY ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-7228
Country : US
Telephone Number : 805-796-8145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2016
Last Update Date : 04/08/2025

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Directions to “ LAUREN HENDERSON ” Practice Location

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