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General NPI Number Information
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NPI Number | 1932368677
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Entity Type | Individual
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Provider Name | ALEX S HAYDON MA
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Gender | Male
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Dates
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Enumeration Date | 06/07/2008
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 3330 HEIGHTS DR STE 120
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City | CAMERON PARK
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State | CA
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Zip | 95682
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Country | US
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Telephone | 408-891-1321
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Fax |
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Provider Business Mailing Address
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Address Line | 3330 HEIGHTS DR STE 120
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City | CAMERON PARK
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State | CA
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Zip | 95682-7769
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Country | US
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Telephone | 408-891-1321
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 51943
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License Number State | CA
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