Provider Demographics
NPI:1912894411
Name:HERNANDEZ, HAYLEY ANN SMITH (MS, RD, LD, CEDS)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:ANN SMITH
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MS, RD, LD, CEDS
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD, CEDS
Mailing Address - Street 1:2659 STATE ST
Mailing Address - Street 2:SUITE 100 #1012
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2659 STATE ST
Practice Address - Street 2:SUITE 100 #1012
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008
Practice Address - Country:US
Practice Address - Phone:855-459-8682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX7254133V00000X
TXDT87567133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered