Healthcare Provider Details

I. General information

NPI: 1750739975
Provider Name (Legal Business Name): HAILEY NICOLE GIFFARD PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 04/26/2022
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 34TH ST
BAKERSFIELD CA
93301-2283
US

IV. Provider business mailing address

PO BOX 1000
BAKERSFIELD CA
93302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 661-868-6600
  • Fax:
Mailing address:
  • Phone: 661-868-6600
  • Fax: 661-868-6666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31396
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: