MEDICARE: MR. ALEX S HAYDON MA

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	101YM0800X	Mental Health Counselor
2	106H00000X	Marriage & Family Therapist	51943	CA

General Provider Information

NPI Number	:	1932368677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALEX S HAYDON MA

Provider Business Mailing Address
First Line	:	3330 HEIGHTS DR STE 120
Second Line	:
City	:	CAMERON PARK
State	:	CA
Zip	:	95682-7769
Country	:	US
Telephone Number	:	408-891-1321
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 HEIGHTS DR STE 120
Second Line	:
City	:	CAMERON PARK
State	:	CA
Zip	:	95682
Country	:	US
Telephone Number	:	408-891-1321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2008
Last Update Date	:	06/13/2018

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Directions to “ MR. ALEX S HAYDON MA” Practice Location

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