Provider Demographics
NPI:1942950936
Name:FEAR, HAILEY LOTTIE (DPT)
Entity Type:Individual
Prefix:DR
First Name:HAILEY
Middle Name:LOTTIE
Last Name:FEAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1946 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SUTTER
Mailing Address - State:CA
Mailing Address - Zip Code:95982-2340
Mailing Address - Country:US
Mailing Address - Phone:530-713-7745
Mailing Address - Fax:
Practice Address - Street 1:851 GRAY AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3652
Practice Address - Country:US
Practice Address - Phone:530-671-8378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301895208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation