Provider Demographics
NPI:1174990014
Name:MEDOFF, HAYLIE
Entity type:Individual
Prefix:
First Name:HAYLIE
Middle Name:
Last Name:MEDOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1592 CHARTERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2778
Mailing Address - Country:US
Mailing Address - Phone:412-576-6500
Mailing Address - Fax:
Practice Address - Street 1:1000 PASEO CAMARILLO STE 108
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-0747
Practice Address - Country:US
Practice Address - Phone:805-504-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA95992355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant