Provider Demographics
NPI:1225417991
Name:HAYWOOD, LAROHN DONNA
Entity type:Individual
Prefix:
First Name:LAROHN
Middle Name:DONNA
Last Name:HAYWOOD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3815
Mailing Address - Country:US
Mailing Address - Phone:310-316-1212
Mailing Address - Fax:
Practice Address - Street 1:410 CAMINO REAL
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3815
Practice Address - Country:US
Practice Address - Phone:310-316-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1248051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical