Healthcare Provider Details

I. General information

NPI: 1124608856
Provider Name (Legal Business Name): HAYLEY LEANNE HUGHES RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date: 05/13/2024
Reactivation Date: 08/29/2024

III. Provider practice location address

350 TERRACINA BLVD
REDLANDS CA
92373-4850
US

IV. Provider business mailing address

913 ARDMORE CIR
REDLANDS CA
92374-6205
US

V. Phone/Fax

Practice location:
  • Phone: 909-335-5500
  • Fax:
Mailing address:
  • Phone: 760-623-3264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86092312
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA65243
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11222
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: