Healthcare Provider Details

I. General information

NPI: 1821925561
Provider Name (Legal Business Name): MICHELE LOUISE HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 3RD ST STE 3
LAGUNA BEACH CA
92651-2376
US

IV. Provider business mailing address

333 3RD ST STE 3
LAGUNA BEACH CA
92651-2376
US

V. Phone/Fax

Practice location:
  • Phone: 949-338-4445
  • Fax:
Mailing address:
  • Phone: 949-338-4445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number129852
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: