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General NPI Number Information
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NPI Number | 1609434356
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Entity Type | Individual
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Provider Name | NEAL HAILEY LMFT #123912
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Gender | Male
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Dates
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Enumeration Date | 05/29/2019
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 7033 THORNHILL DR
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City | OAKLAND
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State | CA
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Zip | 94611-1338
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Country | US
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Telephone | 415-938-7051
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Fax |
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Provider Business Mailing Address
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Address Line | 7033 THORNHILL DR
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City | OAKLAND
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State | CA
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Zip | 94611-1338
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Country | US
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Telephone | 415-519-3870
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 123912
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License Number State | CA
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