Provider Demographics
NPI:1578751061
Name:KHO, HENDY (PMHNP)
Entity Type:Individual
Prefix:
First Name:HENDY
Middle Name:
Last Name:KHO
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:HENDY
Other - Middle Name:
Other - Last Name:HENDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1436 GOODRICH BLVD
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90022-5111
Mailing Address - Country:US
Mailing Address - Phone:323-725-1337
Mailing Address - Fax:323-278-5344
Practice Address - Street 1:4301 WILSON ST
Practice Address - Street 2:
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-4472
Practice Address - Country:US
Practice Address - Phone:833-286-3732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2024-01-09
Deactivation Date:2020-02-29
Deactivation Code:
Reactivation Date:2020-04-30
Provider Licenses
StateLicense IDTaxonomies
CA95016453363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health