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NPI Code Detail

MEDICARE: MRS. ALEJANDRA DE LA ROSA HENDERSON

MEDICARE: MRS. ALEJANDRA DE LA ROSA HENDERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorCA
2225400000XRehabilitation PractitionerCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609331099
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALEJANDRA DE LA ROSA HENDERSON
Provider Business Mailing Address
First Line : 20501 VENTURA BLVD STE 170
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91364-6258
Country : US
Telephone Number : 818-470-9700
Fax Number :
Provider Business Practice Location Address
First Line : 20501 VENTURA BLVD STE 170
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91364-6258
Country : US
Telephone Number : 818-269-8298
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2019
Last Update Date : 05/12/2025

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