Provider Demographics
NPI:1124206222
Name:ASHCRAFT, HAILEY NICOL
Entity Type:Individual
Prefix:MRS
First Name:HAILEY
Middle Name:NICOL
Last Name:ASHCRAFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 BRODERICK ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3304
Mailing Address - Country:US
Mailing Address - Phone:415-292-1760
Mailing Address - Fax:415-292-1636
Practice Address - Street 1:1421 BRODERICK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3304
Practice Address - Country:US
Practice Address - Phone:415-292-1760
Practice Address - Fax:415-292-1636
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health