Provider Demographics
NPI:1568780526
Name:HAILEY, CARLOS REYES (MA)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:REYES
Last Name:HAILEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:ANGEL
Other - Last Name:REYES-HAILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:1390 MARKET ST STE 800
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5323
Mailing Address - Country:US
Mailing Address - Phone:415-626-7000
Mailing Address - Fax:
Practice Address - Street 1:1390 MARKET ST STE 800
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-5323
Practice Address - Country:US
Practice Address - Phone:415-626-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist