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General NPI Number Information
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NPI Number | 1316709629
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Entity Type | Individual
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Provider Name | FRANCIS CHAD HENDERSON
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Gender | Male
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 2051 JOHN JONES RD
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City | DAVIS
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State | CA
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Zip | 95616-9701
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Country | US
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Telephone | 530-758-2060
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Fax |
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Provider Business Mailing Address
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Address Line | 1590 DREW AVE STE 210
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City | DAVIS
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State | CA
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Zip | 95618-7848
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Country | US
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Telephone | 530-285-3285
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95067654
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License Number State | CA
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