Provider Demographics
NPI:1477185528
Name:RASHIDI, HALEY
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:RASHIDI
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 1:325 W HOSPITALITY LN STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3210
Mailing Address - Country:US
Mailing Address - Phone:909-266-2783
Mailing Address - Fax:408-722-3116
Practice Address - Street 1:325 W HOSPITALITY LN STE 103
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3210
Practice Address - Country:US
Practice Address - Phone:909-266-2783
Practice Address - Fax:408-722-3116
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician