MEDICARE: HELEN HAYES

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
1	104100000X	Social Worker	16616	CA
2	1041C0700X	Clinical Social Worker	LCSW64796	CA

General Provider Information

NPI Number	:	1497974927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN HAYES

Provider Business Mailing Address
First Line	:	3188 FRANKLIN AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92113-1429
Country	:	US
Telephone Number	:	323-229-2185
Fax Number	:

Provider Business Practice Location Address
First Line	:	3295 MEADE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-4557
Country	:	US
Telephone Number	:	619-450-1848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	02/04/2021

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Directions to “ HELEN HAYES ” Practice Location

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