Healthcare Provider Details

I. General information

NPI: 1326954801
Provider Name (Legal Business Name): HALEY HANFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9245 LAGUNA SPRINGS DR STE 200
ELK GROVE CA
95758-7991
US

IV. Provider business mailing address

4164 FERNDALE LN
FALLBROOK CA
92028-9428
US

V. Phone/Fax

Practice location:
  • Phone: 760-468-8155
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number6659987
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number260158658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: