Provider Demographics
NPI:1770272429
Name:HAYES, DORIS A (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:A
Last Name:HAYES
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 4074
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90309
Mailing Address - Country:US
Mailing Address - Phone:310-850-4611
Mailing Address - Fax:
Practice Address - Street 1:11900 AVALON BLVD STE 100B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90061-2867
Practice Address - Country:US
Practice Address - Phone:424-468-2194
Practice Address - Fax:310-272-9967
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025046363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health