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NPI Code Detail

MEDICARE: ELIZABETH MARIE HENSLEY

MEDICARE: ELIZABETH MARIE HENSLEY
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
1106H00000XMarriage & Family Therapist157657CA
2172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1669110102
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARIE HENSLEY
Provider Business Mailing Address
First Line : 1840 CAPITOL ST STE B
Second Line :
City : VALLEJO
State : CA
Zip : 94590-5721
Country : US
Telephone Number : 707-440-9923
Fax Number :
Provider Business Practice Location Address
First Line : 1840 CAPITOL ST STE B
Second Line :
City : VALLEJO
State : CA
Zip : 94590-5721
Country : US
Telephone Number : 707-440-9923
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2022
Last Update Date : 11/19/2025

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Directions to “ ELIZABETH MARIE HENSLEY ” Practice Location

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