Individual
MRS. ELISABETH SUSANNE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1775 CHESTNUT AVE, LONG BEACH, CA 90813-1674
(562) 599-8444
(562) 599-5235
Mailing address
1775 CHESTNUT AVE, LONG BEACH, CA 90813-1674
(562) 599-8444
(562) 599-5235
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
232021
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232021
LICENSED VOCATIONAL NURSE
CA
Enumeration date
08/11/2017
Last updated
08/11/2017
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