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General NPI Number Information
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NPI Number | 1174406771
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Entity Type | Individual
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Provider Name | KATELYN HAENNY
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Gender | Female
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 32870 AVENUE E
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City | YUCAIPA
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State | CA
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Zip | 92399-1999
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Country | US
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Telephone | 909-797-5171
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Fax |
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Provider Business Mailing Address
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Address Line | 12791 8TH ST
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City | YUCAIPA
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State | CA
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Zip | 92399-2116
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Country | US
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Telephone |
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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