Provider Demographics
NPI:1992572101
Name:HADLEY, HANNAH HEIDI
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:HEIDI
Last Name:HADLEY
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 1:361 BURSON LN
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-1710
Mailing Address - Country:US
Mailing Address - Phone:805-302-7586
Mailing Address - Fax:
Practice Address - Street 1:5740 RALSTON ST STE 100
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7847
Practice Address - Country:US
Practice Address - Phone:805-289-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program