Provider Demographics
NPI:1790387322
Name:HAYGOOD, VANESSA MARGUERITE (MA)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARGUERITE
Last Name:HAYGOOD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 LA TIJERA BLVD APT H201
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-2163
Mailing Address - Country:US
Mailing Address - Phone:310-486-6684
Mailing Address - Fax:
Practice Address - Street 1:655 DEEP VALLEY DR STE 220
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3661
Practice Address - Country:US
Practice Address - Phone:317-659-0016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist