=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285056416
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HANNAH E FRALEY PHD, APRN, PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2014
-----------------------------------------------------
Last Update Date | 10/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23283 CANYON LAKE DR S
-----------------------------------------------------
City | CANYON LAKE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92587-7598
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-387-0782
-----------------------------------------------------
Fax | 951-639-6087
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31566 RAILROAD CANYON RD STE 2 PMB 191
-----------------------------------------------------
City | CANYON LAKE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92587-9446
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-387-0782
-----------------------------------------------------
Fax | 951-639-6087
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | NP95034067
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | NP865391
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------