Healthcare Provider Details

I. General information

NPI: 1700743754
Provider Name (Legal Business Name): MCKENNA HENDRICKSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

50 DARIEN WAY
SAN FRANCISCO CA
94127-1902
US

IV. Provider business mailing address

1515 QUINTARA ST
SAN FRANCISCO CA
94116-1273
US

V. Phone/Fax

Practice location:
  • Phone: 415-759-2807
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number230303945
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number126956
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: