JONETTA HENDERSON - NPI 1063389518 - Peer Specialist in Woodland, CA

Q: What is the provider's specialty?

The provider's specialty is Peer Specialist with taxonomy code 175T00000X.

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About Jonetta Henderson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONETTA HENDERSON (NPI 1063389518) is an individual peer specialist in Woodland, California, licensed in California (MPSS-BLMFTD) and active in the NPI registry since October 2025.

NPPES Registry Identity

NPI1063389518

Entity TypeIndividualFemale

Primary Taxonomy175T00000X

Provider Legal NameJONETTA HENDERSON

Location Address137 N COTTONWOOD STWoodland, CA 95695-6646

Mailing Address137 N Cottonwood StWoodland, CA 95695-6646 · (530) 312-5127 · Fax (530) 312-5127

Phone(530) 312-5127

Fax(530) 312-5127

Sole ProprietorNo

Enumeration DateOctober 20, 2025

Last NPPES UpdateNovember 6, 2025

NPPES CertifiedNovember 6, 2025

✔ NPI 1063389518 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers

Taxonomy Code175T00000X

License✔ Licensed in CA · MPSS-BLMFTD

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

137 N COTTONWOOD ST, Woodland, CA 95695

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