Healthcare Provider Details

I. General information

NPI: 1497660419
Provider Name (Legal Business Name): KADEN HAYES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 BASE LINE RD
RANCHO CUCAMONGA CA
91730-1350
US

IV. Provider business mailing address

4103 IRISH MOSS LN
SAN BERNARDINO CA
92407-0622
US

V. Phone/Fax

Practice location:
  • Phone: 909-755-5220
  • Fax:
Mailing address:
  • Phone: 909-317-6072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: