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NPI Code Detail

MEDICARE: MR. WILLIAM C HADEN MFC35275

MEDICARE: MR. WILLIAM C HADEN MFC35275
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 CounselorMFC 35275CA
2106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1730332784
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM C HADEN MFC35275
Provider Business Mailing Address
First Line : 621 GREAT JONES ST
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6005
Country : US
Telephone Number : 707-290-8557
Fax Number : 707-429-1809
Provider Business Practice Location Address
First Line : 621 GREAT JONES ST
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6005
Country : US
Telephone Number : 707-290-8557
Fax Number : 707-429-1809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2008
Last Update Date : 08/08/2012

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