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NPI Code Detail

MEDICARE: HAYLEY ANN RYAN

MEDICARE: HAYLEY ANN RYAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1366613341
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAYLEY ANN RYAN
Provider Business Mailing Address
First Line : 2945 MCMILLAN AVE STE 240
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-6771
Country : US
Telephone Number : 805-439-4890
Fax Number :
Provider Business Practice Location Address
First Line : 2945 MCMILLAN AVE STE 240
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-6771
Country : US
Telephone Number : 805-439-4890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2008
Last Update Date : 05/12/2022

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Directions to “ HAYLEY ANN RYAN ” Practice Location

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