Healthcare Provider Details

I. General information

NPI: 1942514682
Provider Name (Legal Business Name): MICHELLE LYN HALEY M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date: 09/04/2020
Reactivation Date: 06/11/2024

III. Provider practice location address

3825 HOPYARD RD SUITE 140 & 202
PLEASANTON CA
94588
US

IV. Provider business mailing address

3825 HOPYARD RD SUITE 140 & 202
PLEASANTON CA
94588
US

V. Phone/Fax

Practice location:
  • Phone: 925-847-5051
  • Fax:
Mailing address:
  • Phone: 925-847-5051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY34620
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: