Healthcare Provider Details

I. General information

NPI: 1932020997
Provider Name (Legal Business Name): CHRISTOPHER MILES HAYDEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 W 78TH ST
LOS ANGELES CA
90044-5002
US

IV. Provider business mailing address

902 W 78TH ST
LOS ANGELES CA
90044-5002
US

V. Phone/Fax

Practice location:
  • Phone: 323-492-4129
  • Fax:
Mailing address:
  • Phone: 323-492-4129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: