Provider Demographics
NPI:1821547019
Name:GATES, HAILEE ELIZABETH (BT)
Entity Type:Individual
Prefix:MRS
First Name:HAILEE
Middle Name:ELIZABETH
Last Name:GATES
Suffix:
Gender:F
Credentials:BT
Other - Prefix:MS
Other - First Name:HAILEE
Other - Middle Name:ELIZABETH
Other - Last Name:REDFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11037 WARNER AVE
Mailing Address - Street 2:#339
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4007
Mailing Address - Country:US
Mailing Address - Phone:800-273-4292
Mailing Address - Fax:949-253-4627
Practice Address - Street 1:11037 WARNER AVE
Practice Address - Street 2:#339
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4007
Practice Address - Country:US
Practice Address - Phone:800-273-4292
Practice Address - Fax:949-253-4627
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other