MEDICARE: ANTHONY HENDRIX BCBA

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
1	103K00000X	Behavior Analyst	1-17-27286	CA

General Provider Information

NPI Number	:	1679085211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY HENDRIX BCBA

Provider Business Mailing Address
First Line	:	2008 JUDAH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94122-1531
Country	:	US
Telephone Number	:	415-565-9775
Fax Number	:

Provider Business Practice Location Address
First Line	:	2008 JUDAH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94122-1531
Country	:	US
Telephone Number	:	415-565-9775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2017
Last Update Date	:	02/19/2024

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