Provider Demographics
NPI:1710435300
Name:ARNOLD, HALEY
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:ARNOLD
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 1:265 S RANDOLPH AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5798
Mailing Address - Country:US
Mailing Address - Phone:657-246-3075
Mailing Address - Fax:714-707-4112
Practice Address - Street 1:265 S RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5754
Practice Address - Country:US
Practice Address - Phone:657-246-3075
Practice Address - Fax:714-707-4112
Is Sole Proprietor?:No
Enumeration Date:2016-09-13
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020817-1225X00000X
CA17523225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist