Provider Demographics
NPI:1790072734
Name:HENDERSON, AMBER E (MSW)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:E
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16756 CHINO-CORONA RD
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:OH
Mailing Address - Zip Code:92878
Mailing Address - Country:US
Mailing Address - Phone:909-597-1771
Mailing Address - Fax:
Practice Address - Street 1:9990 COUNTY FARM RD STE 5
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3542
Practice Address - Country:US
Practice Address - Phone:951-358-4834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker