Provider Demographics
NPI:1801947957
Name:HAYDEN, JULIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16945 PLATINUM PL
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-1173
Mailing Address - Country:US
Mailing Address - Phone:858-848-1766
Mailing Address - Fax:
Practice Address - Street 1:7373 UNIVERSITY AVE STE 113
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-0523
Practice Address - Country:US
Practice Address - Phone:619-797-7319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPSY24184103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health