# MRS. SANDRA LEE HENDRICKSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1083931968
- **Gender:** F
- **Credential:** GERIATRIC NURSE PRAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | 2242 | CA | Yes |

## Other

- **Enumeration date:** 04/30/2010
- **Last updated:** 11/20/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CA147502 | MEDICARE PTAN | CA |