Provider Demographics
NPI:1548790942
Name:HAYHURST-LORIC, ALEXIS HONEY
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:HONEY
Last Name:HAYHURST-LORIC
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 1:1700 YULUPA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-7721
Mailing Address - Country:US
Mailing Address - Phone:707-544-5446
Mailing Address - Fax:
Practice Address - Street 1:1700 YULUPA AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-7721
Practice Address - Country:US
Practice Address - Phone:707-544-5446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor