Healthcare Provider Details

I. General information

NPI: 1619346624
Provider Name (Legal Business Name): MAUREEN HALLETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2015
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 S TREMONT ST
OCEANSIDE CA
92054-5309
US

IV. Provider business mailing address

1738 S TREMONT ST
OCEANSIDE CA
92054-5309
US

V. Phone/Fax

Practice location:
  • Phone: 760-717-5113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: