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Contact Information

CARLETTA Y HENDERSON
12021 WILMINGTON AVE
LOS ANGELES, CA90059-3019
 Phone: 424-758-9601
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ambulatory Care

163WP2201X
Indicates primary specialty

NPI Profile & details for CARLETTA Y HENDERSON · (Female)

NPI # 1104522218
Status Active
Credentials
Entity Individual
Enumeration date 02/01/2023
Last updated 02/01/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 482184
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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