Healthcare Provider Details

I. General information

NPI: 1306537428
Provider Name (Legal Business Name): HADLEY ANN MCGREGOR PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2023
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 BRISTOL ST FL 2
COSTA MESA CA
92626-8605
US

IV. Provider business mailing address

1202 BRISTOL ST FL 2
COSTA MESA CA
92626-8605
US

V. Phone/Fax

Practice location:
  • Phone: 949-267-0400
  • Fax:
Mailing address:
  • Phone: 949-267-0440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY34225
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: