MARYJANE CHINYERE HENSHAW PMHNP
Complete NPI Record 1124853320
Nurse Practitioner - Psychiatric/Mental Health in Folsom, CA
Active since September 06, 2024PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Maryjane Chinyere Henshaw, PMHNP (NPI 1124853320), an individual nurse practitioner provider in Folsom, CA. All 59 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1124853320 Field 1/59
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/59
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: HENSHAW Field 3/59
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: MARYJANE Field 4/59
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: CHINYERE Field 5/59
- The middle name of the provider, if the provider is an individual.
- Provider Credential Text: PMHNP Field 6/59
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 805 BAGGINS CT Field 7/59
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: GALLATIN Field 8/59
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: TN Field 9/59
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 370660016 Field 10/59
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/59
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 6156025375 Field 12/59
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 510 PLAZA DR STE 170 Field 13/59
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: FOLSOM Field 14/59
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: CA Field 15/59
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 956304790 Field 16/59
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 17/59
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 9163519400 Field 18/59
- The telephone number associated with the location address of the provider being identified.
- Provider Gender Code: F Field 21/59
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363LP0808X Field 22/59
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 95032951 Field 23/59
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: CA Field 24/59
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 25/59
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 363LP0808X Field 26/59
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: 0024193966 Field 27/59
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: VA Field 28/59
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 29/59
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 363LP0808X Field 30/59
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 3: 889034 Field 31/59
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 3: NV Field 32/59
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 3: N Field 33/59
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 4: 363LP0808X Field 34/59
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 4: 1206339 Field 35/59
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 4: TX Field 36/59
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 4: N Field 37/59
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 5: 363LP0808X Field 38/59
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 5: 323469 Field 39/59
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 5: AZ Field 40/59
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 5: N Field 41/59
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 6: 363LP0808X Field 42/59
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 6: 5022418 Field 43/59
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 6: NC Field 44/59
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 6: N Field 45/59
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 7: 363LP0808X Field 46/59
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 7: APRN.CNP.0039512 Field 47/59
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 7: OH Field 48/59
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 7: N Field 49/59
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 8: 363LP0808X Field 50/59
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 8: AP61625478 Field 51/59
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 8: WA Field 52/59
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 8: N Field 53/59
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 9: 363LP0808X Field 54/59
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 9: 37173 Field 55/59
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 9: TN Field 56/59
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 9: Y Field 57/59
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Sole Proprietor: Y Field 58/59
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 34
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
2222 Pacific Ave
Location 1/34Stockton, CA 95204-5334 · Phone (916) 351-9400
4025 N Fresno St
Location 2/34Fresno, CA 93726-4026 · Phone (916) 351-9400
805 Baggins Ct
Location 3/34Gallatin, TN 37066-0016 · Phone (615) 602-5375
509 13th St Ste 8
Location 4/34Modesto, CA 95354-2444 · Phone (916) 351-9400
1372 N Main St Ste 206-1
Location 5/34Walnut Creek, CA 94596-4692 · Phone (916) 351-9400
622 Jackson St Unit 103
Location 6/34Fairfield, CA 94533-6195 · Phone (916) 351-9400
1245 W 6th St
Location 7/34Corona, CA 92882-1870 · Phone (916) 351-9400
5441 Aldrin Ct Ste A
Location 8/34Bakersfield, CA 93313-2194 · Phone (916) 351-9400
888 4th St Ste 12
Location 9/34San Rafael, CA 94901-3284 · Phone (916) 351-9400
2386 Fair Oaks Blvd
Location 10/34Sacramento, CA 95825-4741 · Phone (916) 351-9400
3200 4th Ave Ste 200G
Location 11/34San Diego, CA 92103-5716 · Phone (916) 351-9400
2008 W Dorothea Ave Ste 203
Location 12/34Visalia, CA 93277-7300 · Phone (916) 351-9400 · Fax (916) 351-9449
169 Hartnell Ave Ste 110
Location 13/34Redding, CA 96002-1849 · Phone (916) 351-9400 · Fax (916) 351-9449
3711 Long Beach Blvd Ste 4045
Location 14/34Long Beach, CA 90807-3320 · Phone (916) 351-9400 · Fax (916) 351-9449
414 W 21st St
Location 15/34Merced, CA 95340-3718 · Phone (916) 351-9400 · Fax (916) 351-9449
30 E San Joaquin St Ste 203B
Location 16/34Salinas, CA 93901-2947 · Phone (916) 351-9400 · Fax (916) 351-9449
355 W Olive Ave Ste 3
Location 17/34El Centro, CA 92243-3043 · Phone (916) 351-9400 · Fax (916) 351-9449
1040 Park Ave Ste 200-A
Location 18/34San Jose, CA 95126-3075 · Phone (916) 351-9400
2345 Fletcher Pkwy
Location 19/34El Cajon, CA 92020-2134 · Phone (916) 351-9400
225 W Hospitality Ln # 225201P
Location 20/34San Bernardino, CA 92408-3237 · Phone (916) 351-9400
7177 Brockton Ave Ste 444A
Location 21/34Riverside, CA 92506-2635 · Phone (916) 351-9400
2062 Talbert Dr Ste 100
Location 22/34Chico, CA 95928-7718 · Phone (916) 351-9400
15720 Ventura Blvd Ste 210
Location 23/34Encino, CA 91436-2954 · Phone (916) 351-9400
55 Hitchcock Way Ste 209
Location 24/34Santa Barbara, CA 93105-5635 · Phone (916) 351-9400 · Fax (916) 351-9449
44240 Fremont Blvd
Location 25/34Fremont, CA 94538-6000 · Phone (916) 351-9400
1254 Mission St Ste 220
Location 26/34San Francisco, CA 94103-2706 · Phone (916) 351-9400
7365 Carnelian St Ste 222F
Location 27/34Rancho Cucamonga, CA 91730-1157 · Phone (916) 351-9400
634 H St
Location 28/34Eureka, CA 95501-1053 · Phone (916) 351-9400 · Fax (916) 351-9449
1825 N Oxnard Blvd Ste 19
Location 29/34Oxnard, CA 93030-3503 · Phone (916) 351-9400 · Fax (916) 351-9449
9381 E Stockton Blvd Ste 220
Location 30/34Elk Grove, CA 95624-5070 · Phone (916) 351-9400
1501 W Cameron Ave Ste 300-129
Location 31/34West Covina, CA 91790-2724 · Phone (916) 351-9400
1101 Maidu Dr
Location 32/34Auburn, CA 95603-5864 · Phone (916) 351-9400
2955 Main St Ste 110-K
Location 33/34Irvine, CA 92614-5909 · Phone (916) 351-9400
2440 Professional Dr
Location 34/34Roseville, CA 95661-7773 · Phone (916) 351-9400
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