Individual
DEBORAH L. HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
72780 COUNTRY CLUB DR, BLDG B 203, RANCHO MIRAGE, CA 92270-4126
(760) 674-3847
(760) 674-3845
Mailing address
72780 COUNTRY CLUB DR, BLDG B 203, RANCHO MIRAGE, CA 92270-4126
(760) 674-3847
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17812
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00246545
GOOD SAMARITAN RAILROAD
CA
05
—
PA17812
—
CA
Enumeration date
05/22/2006
Last updated
03/01/2016
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