MEDICARE: NATHAN HALE PSY.D.

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	103TC0700X	Clinical Psychologist	PSY30044	CA

General Provider Information

NPI Number	:	1972753069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN HALE PSY.D.

Provider Business Mailing Address
First Line	:	5758 GEARY BLVD # 626
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94121-2112
Country	:	US
Telephone Number	:	604-802-4575
Fax Number	:	866-339-6771

Provider Business Practice Location Address
First Line	:	5758 GEARY BLVD # 626
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94121-2112
Country	:	US
Telephone Number	:	604-802-4575
Fax Number	:	866-339-6771

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

Provider Enumeration Date	:	09/24/2008
Last Update Date	:	10/30/2025

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