Provider Demographics
NPI:1437451861
Name:HALE, THALIA MARYAM (ND)
Entity Type:Individual
Prefix:DR
First Name:THALIA
Middle Name:MARYAM
Last Name:HALE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 MIDDLEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-3000
Mailing Address - Country:US
Mailing Address - Phone:650-485-2758
Mailing Address - Fax:650-397-5360
Practice Address - Street 1:3200 MIDDLEFIELD RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-3000
Practice Address - Country:US
Practice Address - Phone:650-485-2758
Practice Address - Fax:650-397-5360
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath