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NPI Code Detail

MEDICARE: HALEY ROSEN PSY.D.

MEDICARE: HALEY ROSEN PSY.D.
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1376275883
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY ROSEN PSY.D.
Provider Business Mailing Address
First Line : 13956 RAMHURST DR APT 9
Second Line :
City : LA MIRADA
State : CA
Zip : 90638-1741
Country : US
Telephone Number : 541-206-7311
Fax Number :
Provider Business Practice Location Address
First Line : 16756 CHINO CORONA RD
Second Line :
City : EASTVALE
State : CA
Zip : 92880-9508
Country : US
Telephone Number : 909-597-1771
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2022
Last Update Date : 06/25/2022

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