Provider Demographics
NPI:1922665249
Name:HAYES, LORAN PATRICK (PHD)
Entity Type:Individual
Prefix:DR
First Name:LORAN
Middle Name:PATRICK
Last Name:HAYES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 E RIO WAY
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093-6812
Mailing Address - Country:US
Mailing Address - Phone:831-905-0649
Mailing Address - Fax:
Practice Address - Street 1:114 E 12450 S
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8058
Practice Address - Country:US
Practice Address - Phone:801-523-3001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11111392-2501103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical