Individual
JANET HENDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2051 JOHN JONES RD, DAVIS, CA 95616
(530) 753-3498
Mailing address
PO BOX 1260, DAVIS, CA 95617-1260
(530) 753-3498
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
22444
CA
363L00000X
Nurse Practitioner
Primary
22990
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22444
STATE LICENSE
CA
Enumeration date
08/06/2012
Last updated
08/08/2018
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