Individual
WESLEY EARL HENDRIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
137 N COTTONWOOD ST, WOODLAND, CA 95695-6646
(530) 666-8630
Mailing address
137 N COTTONWOOD ST, WOODLAND, CA 95695-6646
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT37224
CA
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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