Provider Demographics
NPI:1275016537
Name:NILES, HAYLEY MELISSA (LMFT)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:MELISSA
Last Name:NILES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ANACAPA CT
Mailing Address - Street 2:
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-2421
Mailing Address - Country:US
Mailing Address - Phone:949-338-9667
Mailing Address - Fax:
Practice Address - Street 1:25401 CABOT RD STE 217
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5514
Practice Address - Country:US
Practice Address - Phone:562-434-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108738106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist