Healthcare Provider Details

I. General information

NPI: 1881424059
Provider Name (Legal Business Name): ALULA HAILE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2024
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LAS PALMAS DR
IRVINE CA
92602-2311
US

IV. Provider business mailing address

2102 BUSINESS CENTER DR STE 2001
IRVINE CA
92612-1001
US

V. Phone/Fax

Practice location:
  • Phone: 949-345-0461
  • Fax: 478-780-6088
Mailing address:
  • Phone: 949-345-0461
  • Fax: 478-780-6088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95028767
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: