Healthcare Provider Details

I. General information

NPI: 1699893578
Provider Name (Legal Business Name): DAVID C. HAYES MA., MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9171 WILSHIRE BLVD SUITE 680-2
BEVERLY HILLS CA
90210-5530
US

IV. Provider business mailing address

9171 WILSHIRE BLVD SUITE 680-2
BEVERLY HILLS CA
90210-5530
US

V. Phone/Fax

Practice location:
  • Phone: 310-975-9024
  • Fax: 310-273-1010
Mailing address:
  • Phone: 310-975-9024
  • Fax: 310-273-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMFC42851
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: