Healthcare Provider Details

I. General information

NPI: 1306724950
Provider Name (Legal Business Name): KALEY HAYMOND ACCNS-N
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W LA VETA AVE
ORANGE CA
92868-4203
US

IV. Provider business mailing address

25845 VIA PERA
MISSION VIEJO CA
92691-2424
US

V. Phone/Fax

Practice location:
  • Phone: 714-509-9590
  • Fax:
Mailing address:
  • Phone: 949-505-4199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number5196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: