Provider Demographics
NPI:1417265794
Name:HAFNER, HILLERY KATHRINE (MS)
Entity Type:Individual
Prefix:MS
First Name:HILLERY
Middle Name:KATHRINE
Last Name:HAFNER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 S COAST DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-1534
Mailing Address - Country:US
Mailing Address - Phone:949-515-5440
Mailing Address - Fax:
Practice Address - Street 1:1503 S COAST DR
Practice Address - Street 2:SUITE 202
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1534
Practice Address - Country:US
Practice Address - Phone:949-515-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist