Healthcare Provider Details

I. General information

NPI: 1003508565
Provider Name (Legal Business Name): GABRIELLE HAYON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABY HAYON

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MARIN ST STE 112
THOUSAND OAKS CA
91360-4265
US

IV. Provider business mailing address

27058 ESWARD DR
AGOURA HILLS CA
91301-2323
US

V. Phone/Fax

Practice location:
  • Phone: 805-413-0790
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: