Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Breanna Henderson

Individual provider Physical Therapist · NPI 1073885711

Breanna Henderson is a Physical Therapist in Private Practice in Riverside, California. Qualified in 2007, 19 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
19
Licensed in
CA
In the registry since
2012
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Practice location Address checks out

3865 Jackson St
Riverside, CA 92503-3919
Phone: (951) 688-2211
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 34068 (CA)

Record details

NPI number1073885711
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 26, 2012
Last updated in NPPESDecember 23, 2021
Certification dateDecember 23, 2021
Mailing address3865 Jackson St, Riverside, CA 92503-3919

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Riverside