Healthcare Provider Details

I. General information

NPI: 1255511424
Provider Name (Legal Business Name): AMBER HAYSLETT-ATKISON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER HAYSLETT LMFT

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 428
DENAIR CA
95316-0428
US

IV. Provider business mailing address

PO BOX 428
DENAIR CA
95316-0428
US

V. Phone/Fax

Practice location:
  • Phone: 925-918-2105
  • Fax:
Mailing address:
  • Phone: 925-918-2105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number51684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: