Provider Demographics
NPI:1457531709
Name:VENTER, HENDRIK J (PHD)
Entity Type:Individual
Prefix:DR
First Name:HENDRIK
Middle Name:J
Last Name:VENTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 BEACHPORT DR
Mailing Address - Street 2:
Mailing Address - City:PORT HUENEME
Mailing Address - State:CA
Mailing Address - Zip Code:93041-3068
Mailing Address - Country:US
Mailing Address - Phone:559-930-3812
Mailing Address - Fax:559-917-5935
Practice Address - Street 1:688 BEACHPORT DR
Practice Address - Street 2:
Practice Address - City:PORT HUENEME
Practice Address - State:CA
Practice Address - Zip Code:93041-3068
Practice Address - Country:US
Practice Address - Phone:559-930-3812
Practice Address - Fax:559-917-5935
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-04
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 18428103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical