Provider Demographics
NPI:1639152598
Name:HENDREN, ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:HENDREN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UCSF LPPI
Mailing Address - Street 2:401 PARNASSUS AVE, BOX 0984
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0984
Mailing Address - Country:US
Mailing Address - Phone:415-476-7198
Mailing Address - Fax:415-476-7320
Practice Address - Street 1:401 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0984
Practice Address - Country:US
Practice Address - Phone:415-476-7198
Practice Address - Fax:415-476-7320
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A45722084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX45720Medicaid
CAE89025Medicare UPIN