Provider Demographics
NPI:1942921697
Name:HAYSELDEN, TASHEDA J (MD, PSYD)
Entity Type:Individual
Prefix:DR
First Name:TASHEDA
Middle Name:J
Last Name:HAYSELDEN
Suffix:
Gender:F
Credentials:MD, PSYD
Other - Prefix:DR
Other - First Name:TASHEDA
Other - Middle Name:J
Other - Last Name:LEONARD-HAYSELDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PSYD
Mailing Address - Street 1:14740 BASS DR SPC 8
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-8403
Mailing Address - Country:US
Mailing Address - Phone:619-738-4017
Mailing Address - Fax:
Practice Address - Street 1:14740 BASS DR SPC 8
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-8403
Practice Address - Country:US
Practice Address - Phone:619-738-4017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0091799OtherWOLLCARE COMMUNITY HEALTH NETWORK