Provider Demographics
NPI:1396412771
Name:HENDRICKS, BETHANY STOKES
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:STOKES
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4993 GOLDEN FOOTHILL PKWY STE 5
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9642
Mailing Address - Country:US
Mailing Address - Phone:916-718-2023
Mailing Address - Fax:
Practice Address - Street 1:4993 GOLDEN FOOTHILL PKWY STE 5
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9642
Practice Address - Country:US
Practice Address - Phone:916-718-2023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist