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General NPI Number Information
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NPI Number | 1063793909
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Entity Type | Individual
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Provider Name | LAQEISHIA SHARRICE HAGANS EDD
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Gender | Female
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 27261 LAS RAMBLAS STE 220
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6468
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Country | US
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Telephone | 909-519-6159
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 W REDLANDS BLVD UNIT 12117
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City | SAN BERNARDINO
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State | CA
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Zip | 92423-2486
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Country | US
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Telephone | 909-312-9480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY32704
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY32704
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY32704
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY32704
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License Number State | CA
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