Provider Demographics
NPI:1942514682
Name:HALEY, MICHELLE LYN (MA)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LYN
Last Name:HALEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 HOPYARD RD SUITE 140 & 202
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588
Mailing Address - Country:US
Mailing Address - Phone:925-847-5051
Mailing Address - Fax:
Practice Address - Street 1:3825 HOPYARD RD SUITE 140 & 202
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588
Practice Address - Country:US
Practice Address - Phone:925-847-5051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2024-11-04
Deactivation Date:2020-09-04
Deactivation Code:
Reactivation Date:2024-06-11
Provider Licenses
StateLicense IDTaxonomies
CAPSY34620103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical