Provider Demographics
NPI:1326373929
Name:HAYES, REGINALD ROOSEVELT SR
Entity Type:Individual
Prefix:MR
First Name:REGINALD
Middle Name:ROOSEVELT
Last Name:HAYES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 CHINOOK CT
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94130-1630
Mailing Address - Country:US
Mailing Address - Phone:415-746-1967
Mailing Address - Fax:
Practice Address - Street 1:1443 CHINOOK CT
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94130-1630
Practice Address - Country:US
Practice Address - Phone:415-746-1967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor