Basic Information
| Provider Information | |||||||||
| NPI: | 1437801446 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KIRZY | ||||||||
| FirstName: | HALEY | ||||||||
| MiddleName: | DANIELLE DAWN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18225 HALE AVE | ||||||||
| Address2: | |||||||||
| City: | MORGAN HILL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950373547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4084658280 | ||||||||
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| Practice Location | |||||||||
| Address1: | 215 HUERTA AVE | ||||||||
| Address2: | |||||||||
| City: | GREENFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939275762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8316742180 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2022 | ||||||||
| LastUpdateDate: | 01/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 164X00000X | 717690 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.