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General NPI Number Information
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NPI Number | 1639985005
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Entity Type | Individual
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Provider Name | DR. RAMAR HENDERSON
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Gender | Male
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 410 W FALLBROOK AVE STE 105
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City | FRESNO
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State | CA
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Zip | 93711-6191
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Country | US
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Telephone | 559-549-3673
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Fax |
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Provider Business Mailing Address
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Address Line | 839 SUNSET BLVD
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City | ARCADIA
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State | CA
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Zip | 91007-6557
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Country | US
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Telephone | 559-549-3673
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 11714
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 543553
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11714
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License Number State | CA
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