Provider Demographics
NPI:1396963641
Name:HAYDEN, KATHY ANN (MFT 28468 CA)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:ANN
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:MFT 28468 CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 N THORNE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-5982
Mailing Address - Country:US
Mailing Address - Phone:559-917-8599
Mailing Address - Fax:559-222-0731
Practice Address - Street 1:611 E BELMONT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-1502
Practice Address - Country:US
Practice Address - Phone:559-251-4800
Practice Address - Fax:559-453-7827
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28468106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist