Provider Demographics
NPI:1295437499
Name:KHALAF, HAYA
Entity type:Individual
Prefix:
First Name:HAYA
Middle Name:
Last Name:KHALAF
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 1:425 CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-4215
Mailing Address - Country:US
Mailing Address - Phone:650-267-9697
Mailing Address - Fax:
Practice Address - Street 1:425 CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-4215
Practice Address - Country:US
Practice Address - Phone:650-267-9697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist