Healthcare Provider Details

I. General information

NPI: 1245602952
Provider Name (Legal Business Name): WENDY HAYES CMA (AAMA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 GOLDEN SHR SUITE 250
LONG BEACH CA
90802-4246
US

IV. Provider business mailing address

309 N LANGSTAFF ST UNIT A
LAKE ELSINORE CA
92530-3713
US

V. Phone/Fax

Practice location:
  • Phone: 562-256-7550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2466900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: