Provider Demographics
NPI:1013208206
Name:HAYNES, FRAN (MFT)
Entity Type:Individual
Prefix:
First Name:FRAN
Middle Name:
Last Name:HAYNES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 HIDDEN ACRE RD
Mailing Address - Street 2:
Mailing Address - City:MEADOW VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:95722-9455
Mailing Address - Country:US
Mailing Address - Phone:530-878-0228
Mailing Address - Fax:
Practice Address - Street 1:884 LINCOLN WAY
Practice Address - Street 2:SUITE 34-B
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-4825
Practice Address - Country:US
Practice Address - Phone:530-878-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25554106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist