Basic Information
Provider Information
NPI: 1699893578
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAYES
FirstName: DAVID
MiddleName: C.
NamePrefix: MR.
NameSuffix:  
Credential: MA., MFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9171 WILSHIRE BLVD
Address2: SUITE 680-2
City: BEVERLY HILLS
State: CA
PostalCode: 902105530
CountryCode: US
TelephoneNumber: 3109759024
FaxNumber: 3102731010
Practice Location
Address1: 9171 WILSHIRE BLVD
Address2: SUITE 680-2
City: BEVERLY HILLS
State: CA
PostalCode: 902105530
CountryCode: US
TelephoneNumber: 3109759024
FaxNumber: 3102731010
Other Information
ProviderEnumerationDate: 03/27/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XMFC42851CAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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