Individual
NICOLE RAE HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO
Contact information
Practice address
2550 23RD ST STE 119, SAN FRANCISCO, CA 94110-3504
(415) 206-4387
(415) 206-4389
Mailing address
2550 23RD ST RM 119, SAN FRANCISCO, CA 94110-3504
(415) 206-4387
(415) 206-4389
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
224P00000X
Prosthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPO04230
AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS, INC.
—
Enumeration date
03/26/2019
Last updated
03/26/2019
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