1992903272 NPI number — MRS. MELANIE LOUISE HAYNES L.C.S.W.

Table of content: MRS. MELANIE LOUISE HAYNES L.C.S.W. (NPI 1992903272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992903272 NPI number — MRS. MELANIE LOUISE HAYNES L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAYNES
Provider First Name:
MELANIE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAYNES
Provider Other First Name:
MELANIE
Provider Other Middle Name:
DAVIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992903272
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSFIELD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93302-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-758-7332
Provider Business Mailing Address Fax Number:
661-758-7302

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
930 F ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93280-2040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-758-7300
Provider Business Practice Location Address Fax Number:
661-758-7302
Provider Enumeration Date:
07/06/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  15524 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)