Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G71221 | CA |
NPI | 1295813905 |
---|---|
Provider Name | Colleen M. Hendershott |
First Address | Oakland, CA 94612-3466 |
Second Address | Roseville, CA 95661-3027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 03/12/2021 |