Healthcare Provider Details

I. General information

NPI: 1790617561
Provider Name (Legal Business Name): HAYLEY HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 WEST MALL
ATASCADERO CA
93422-4234
US

IV. Provider business mailing address

9180 SEVILLE LN UNIT 105
ATASCADERO CA
93422-8882
US

V. Phone/Fax

Practice location:
  • Phone: 559-737-7252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: