Healthcare Provider Details

I. General information

NPI: 1639783277
Provider Name (Legal Business Name): MR. STEVEN A HENDRIX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2020
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 OLIVER RD STE 200
FAIRFIELD CA
94534-3428
US

IV. Provider business mailing address

7255 GREENLEAF AVE STE 20
WHITTIER CA
90602-1340
US

V. Phone/Fax

Practice location:
  • Phone: 707-681-0601
  • Fax: 707-637-8263
Mailing address:
  • Phone: 562-945-2000
  • Fax: 562-324-6190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-50636
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: