MEDICARE: HAYLEE R DURAN LICENSED MARRIAGE AND FAMILY THERAPIST A PROF CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1205705993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAYLEE R DURAN LICENSED MARRIAGE AND FAMILY THERAPIST A PROF CORP

Provider Business Mailing Address
First Line	:	1611 S PACIFIC COAST HWY STE 200E
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5611
Country	:	US
Telephone Number	:	424-260-3955
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 S PACIFIC COAST HWY STE 200E
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5611
Country	:	US
Telephone Number	:	424-260-3955
Fax Number	:

Authorized Official
Title or Position	:	LMFT, OWNER
Name	:	HAYLEE DURAN
Credential	:	LMFT
Telephone Number	:	310-387-1833

Provider Enumeration Date	:	11/01/2025
Last Update Date	:	11/01/2025

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