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Individual

TAMMY HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8300 S VERMONT AVE, LOS ANGELES, CA 90044-3493
(323) 965-4337
Mailing address
8300 S VERMONT AVE, LOS ANGELES, CA 90044-3493
(323) 965-4337

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
741592
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
741592
CA

Other

Enumeration date
08/24/2016
Last updated
03/11/2021
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