Individual
CARLETTA Y HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12021 WILMINGTON AVE, LOS ANGELES, CA 90059-3019
(424) 758-9601
Mailing address
12021 WILMINGTON AVE, LOS ANGELES, CA 90059-3019
(424) 758-9601
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
482184
CA
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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