Healthcare Provider Details

I. General information

NPI: 1679725360
Provider Name (Legal Business Name): DEBRA COLDIRON HADDEN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 09/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7624 PAINTER AVENUE SUITE 200-201
WHITTIER CA
90602-2300
US

IV. Provider business mailing address

PO BOX 1617
LA MIRADA CA
90637-1617
US

V. Phone/Fax

Practice location:
  • Phone: 310-218-6405
  • Fax: 562-907-4174
Mailing address:
  • Phone: 310-218-6405
  • Fax: 562-907-4174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY23938
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY23938
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY23938
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY23938
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: