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KENYA HENDERSON PAC
NPI 1740369867
Physician Assistant - Medical in Mission Hills, CA

Active since November 02, 2006PECOS Enrolled
11600 INDIAN HILLS RD, MISSION HILLS, CA 91345(818) 838-4500 Get Directions Write a Review

NPPES record last updated: December 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 17, 2025, Feb 26, 2018 (2 updates tracked since 2018).

About Kenya Henderson Pac NPPES

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

KENYA HENDERSON PAC (NPI 1740369867) is an individual medical provider in Mission Hills, California, licensed in California (PA15124) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740369867
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameKENYA HENDERSONCredential: PAC
Location Address11600 INDIAN HILLS RDMission Hills, CA 91345-1225
Mailing AddressPo Box 35380Las Vegas, NV 89133-5380 · (702) 579-3203
Phone(818) 838-4500
Sole ProprietorNo
Enumeration DateNovember 2, 2006
Last NPPES UpdateDecember 17, 20252 updates tracked since enumeration
NPPES CertifiedDecember 17, 2025
✔ NPI 1740369867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CA · PA15124
11600 INDIAN HILLS RD, Mission Hills, CA 91345
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Other Names 1

Former Name (1)Kenya Greene Pac

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenya Henderson Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL LESLEE POTRUCH MD
Obstetrics & Gynecology
11600 INDIAN HILLS RD, SUITE 201
MISSION HILLS, CA 91345
Los Angeles County (818) 838-4535
DR. DONALD REBHUN MD
Internal Medicine
11600 INDIAN HILLS RD
MISSION HILLS, CA 91345
Los Angeles County (818) 838-4510
SARA WONG D.O
Internal Medicine
11600 INDIAN HILLS RD, SUITE 200
MISSION HILLS, CA 91345
Los Angeles County (818) 838-4587
DR. GLENN MARK GROSSMAN M.D.
Obstetrics & Gynecology
11600 INDIAN HILLS RD, SUITE 200
MISSION HILLS, CA 91345
Los Angeles County (818) 838-4500
DR. LUISA FERNANDA AREVALO MD
Family Medicine
11600 INDIAN HILLS RD
MISSION HILLS, CA 91345
Los Angeles County (818) 838-4500
ARCHANA KULAI M.D.
Family Medicine
11600 INDIAN HILLS RD
MISSION HILLS, CA 91345
Los Angeles County (818) 838-4590
DR. KENDRICK KANG-JOH JEONG M.D.
Internal Medicine
11600 INDIAN HILLS RD
MISSION HILLS, CA 91345
Los Angeles County (818) 838-4500
DR. YVETTE D DAVID M.D.
Internal Medicine (Gastroenterology)
11600 INDIAN HILLS RD
MISSION HILLS, CA 91345
Los Angeles County (818) 838-4500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenya Henderson's NPI number?

The NPI number for Kenya Henderson is 1740369867. It was assigned to this individual provider in the NPPES registry on November 2, 2006. The provider is also known as Kenya Greene Pac.

Where is Kenya Henderson located?

Kenya Henderson practices at 11600 Indian Hills Rd, Mission Hills, CA 91345. The listed phone number is (818) 838-4500.

What is Kenya Henderson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kenya Henderson enrolled in Medicare?

Yes. Kenya Henderson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenya Henderson was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.