Provider Demographics
NPI:1356080121
Name:HAYES, MELANIE (LMFT)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5650 OLINDA RD
Mailing Address - Street 2:
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803-3540
Mailing Address - Country:US
Mailing Address - Phone:510-815-0341
Mailing Address - Fax:
Practice Address - Street 1:5650 OLINDA RD
Practice Address - Street 2:
Practice Address - City:EL SOBRANTE
Practice Address - State:CA
Practice Address - Zip Code:94803-3540
Practice Address - Country:US
Practice Address - Phone:925-915-4496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA134466106H00000X
CAAMFT123072101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA134466OtherBOARD OF BEHAVIORAL SCIENCES
CAAMFT123072OtherBOARD OF BEHAVIORAL SCIENCES