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General NPI Number Information
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NPI Number | 1528229671
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Entity Type | Individual
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Provider Name | CHARITY ANN PLAXTON HENNINGS PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 1881 BUSINESS CENTER DR SUITE 11
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3465
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Country | US
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Telephone | 909-553-0547
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Fax | 909-384-0734
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Provider Business Mailing Address
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Address Line | PO BOX 659
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City | BRYN MAWR
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State | CA
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Zip | 92318-0659
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Country | US
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Telephone | 909-553-0547
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Fax | 909-384-0734
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 20627
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License Number State | CA
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