Individual
RONALD J HENRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
751 S BASCOM AVE, ANESHESIOLOGY DEPARTMENT, SAN JOSE, CA 95128-2604
(408) 885-5745
Mailing address
751 S BASCOM AVE, SAN JOSE, CA 95128-2604
(408) 885-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
286590
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN286590
—
CA
Enumeration date
04/13/2006
Last updated
09/12/2007
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