Basic Information
| Provider Information | |||||||||
| NPI: | 1518103605 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DAVID HAYES PSYCHOLOGICAL SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9171 WILSHIRE BLVD | ||||||||
| Address2: | 680-2 | ||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902105530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3109759024 | ||||||||
| FaxNumber: | 3102731010 | ||||||||
| Practice Location | |||||||||
| Address1: | 9171 WILSHIRE BLVD | ||||||||
| Address2: | 680-2 | ||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902105530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3109759024 | ||||||||
| FaxNumber: | 3102731010 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2008 | ||||||||
| LastUpdateDate: | 12/19/2008 | ||||||||
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| AuthorizedOfficialLastName: | HAYES | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3109759024 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MFT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFC42851 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.