Provider Demographics
NPI:1902295280
Name:HIRST, RAYNA (PHD)
Entity Type:Individual
Prefix:
First Name:RAYNA
Middle Name:
Last Name:HIRST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1791 ARASTRADERO RD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1337
Mailing Address - Country:US
Mailing Address - Phone:650-417-2025
Mailing Address - Fax:
Practice Address - Street 1:833 MARKET ST
Practice Address - Street 2:SUITE 809
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1814
Practice Address - Country:US
Practice Address - Phone:415-627-9095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26398103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist