Healthcare Provider Details

I. General information

NPI: 1205511615
Provider Name (Legal Business Name): MEGHAN LOUISE HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S INDIAN HILL BLVD
CLAREMONT CA
91711-5444
US

IV. Provider business mailing address

8653 ANDOVER PL
RANCHO CUCAMONGA CA
91730-4744
US

V. Phone/Fax

Practice location:
  • Phone: 909-476-2023
  • Fax:
Mailing address:
  • Phone: 626-639-9616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: