Individual
DENISE HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
11660 FULTON CT, VICTORVILLE, CA 92392-0456
(760) 245-8837
Mailing address
12240 HESPERIA RD, VICTORVILLE, CA 92395
(760) 245-8837
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN255602
CA
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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