Healthcare Provider Details

I. General information

NPI: 1700110418
Provider Name (Legal Business Name): VICTORIA LYNNE HAYES DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 09/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
STANFORD CA
94305-2200
US

IV. Provider business mailing address

3646 DEEDHAM DR
SAN JOSE CA
95148-3111
US

V. Phone/Fax

Practice location:
  • Phone: 650-725-5106
  • Fax:
Mailing address:
  • Phone: 408-274-8587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number35858
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: