Individual
MRS. SANDRA LEE HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GERIATRIC NURSE PRAC
Contact information
Practice address
1011 CASS ST STE 107, MONTEREY, CA 93940-4542
(831) 324-0416
Mailing address
284 FOREST RIDGE RD, MONTEREY, CA 93940-4101
(831) 236-5802
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2242
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA147502
MEDICARE PTAN
CA
Enumeration date
04/30/2010
Last updated
11/20/2015
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