Provider Demographics
NPI:1336020346
Name:HENDRIX, JILLIAN FLORENCE (APCC)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:FLORENCE
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5980 OAK KNOLLS RD
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-4628
Mailing Address - Country:US
Mailing Address - Phone:805-433-5833
Mailing Address - Fax:
Practice Address - Street 1:5980 OAK KNOLLS RD
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-4628
Practice Address - Country:US
Practice Address - Phone:805-433-5833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC15617101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty