Provider Demographics
NPI:1851044762
Name:MCDEVITT, HALEY
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:MCDEVITT
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 1:1500 N GRAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2611
Mailing Address - Country:US
Mailing Address - Phone:949-400-1014
Mailing Address - Fax:
Practice Address - Street 1:5222 ROYALE AVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-3139
Practice Address - Country:US
Practice Address - Phone:949-400-1014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other