Stacey Edwina Hendricks, is a 
Community Health Worker based in Vallejo, California. Stacey Edwina Hendricks is licensed to practice in * (Not Available) (license number ) and her current practice location is 
908 Tuolumne St, Vallejo, California. She can be reached at her office (for appointments etc.) via phone at 
(707) 648-8121.
NPI number for Stacey Edwina Hendricks is 1235878190 and her current mailing address is 908 Tuolumne St, Vallejo, California. She 
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1235878190.
			
			
			
		 
		
		 
Healthcare Provider's Profile
		
			
			
			| Full Name | Stacey Edwina Hendricks | 
|---|
| Gender | Female | 
|---|
| Speciality | Community Health Worker | 
|---|
| Location | 908 Tuolumne St, Vallejo, California | 
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. | 
			
			 
			
						  NPI Data:
			
			- NPI Number: 1235878190
 - Provider Enumeration Date: 05/31/2022
 - Last Update Date: 05/08/2025
 			
			
			 
		 
		 
Medical Identifiers
		Medical identifiers for Stacey Edwina Hendricks such as npi, medicare ID, medicare PIN, medicaid, etc.
		
		| Identifier | Type | State | Issuer | 
		| 1235878190 | NPI | - | NPPES | 
		
		 
Medical Taxonomies and Licenses
		
		| Taxonomy | Type | License (State) | Status | 
		| 101Y00000X | Counselor  |  (* (Not Available)) | Secondary | 
| 372600000X | Adult Companion  |  (* (Not Available)) | Secondary | 
| 172V00000X | Community Health Worker  |  (* (Not Available)) | Primary | 
		
		
			
			
			
		
		
		 
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacey Edwina Hendricks is 
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
		
		
 
Mailing Address and Practice Location
		
		| Mailing Address | Practice Location Address | 
		Stacey Edwina Hendricks, 908 Tuolumne St, Vallejo, CA 94590-4641 Ph: () - | Stacey Edwina Hendricks, 908 Tuolumne St, Vallejo, CA 94590-4641 Ph: (707) 648-8121 | 
		
		 
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