Provider Demographics
NPI:1275222770
Name:THAYER, HAYDEN J (DPT)
Entity type:Individual
Prefix:
First Name:HAYDEN
Middle Name:J
Last Name:THAYER
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:HAYDEN
Other - Middle Name:JAMES
Other - Last Name:THAYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:2441 E KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-2415
Mailing Address - Country:US
Mailing Address - Phone:208-721-3034
Mailing Address - Fax:
Practice Address - Street 1:1700 CALIFORNIA ST STE 530
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4591
Practice Address - Country:US
Practice Address - Phone:415-921-1758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251X0800X
CA3062422251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic