Haley Kendall Provan

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

147097 Issued in CA

Practice address

8885 Rio San Diego Dr Ste 367
San Diego, CA 92108-1655

Phone

(858) 232-6266

NPI assigned

Sep 16, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Monica Perlman MD Inc.

  • Primary Care Clinic/Center
  • La Jolla, CA
  • NPI 1134309305
  Medicare reassignment NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD (past)
• UC San Diego Health - Rancho Family Medical Group

  • Multi-Specialty Clinic/Center
  • Temecula, CA
  • NPI 1003385071
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1467068320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8885 RIO SAN DIEGO DR STE 367",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081655",
            "telephone_number": "858-232-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8885 RIO SAN DIEGO DR STE 367",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081655",
            "telephone_number": "858-232-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVAN",
        "first_name": "HALEY",
        "middle_name": "KENDALL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "147097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Proton Doctors Professional Corporation
• Jocelyn C Protopappas, RDN, MSW, MPH
• Nicholas James Protopsaltis, MD, PHD
• Lucy Proudfoot
• David Proulx, DAVID PROULX
• Jenessa Rae Provence
• Sara Provence
• Christine Marie Provencher
• Paul Louis Provencio
• Marisa Provenzano, LCSW

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.