Individual
MS. KYWINA MARIE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP, PMHNP-BC
Contact information
Practice address
13425 VENTURA BLVD STE 201, SHERMAN OAKS, CA 91423-3974
(818) 305-6061
Mailing address
1609 VERMONT PL, POMONA, CA 91768-1461
(909) 788-4638
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
17177
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
17177
CA
Other
Enumeration date
06/06/2007
Last updated
06/21/2022
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