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Organization
WAY OF LIGHT LOVE
Active
Organization
WAY OF LIGHT LOVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TASHEDA J LEONARD-HAYSELDEN MD, PSYD (CEO)
(619) 738-4017
Entity
Organization
Contact information
Practice address
14740 BASS DR SPC 8, REDDING, CA 96003-8403
(619) 738-4017
Mailing address
14740 BASS DR SPC 8, REDDING, CA 96003-8403
(619) 738-4017
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
172V00000X
Community Health Worker
Primary
—
—
174200000X
Meals Provider
—
—
175T00000X
Peer Specialist
—
—
177F00000X
Lodging Provider
—
—
183500000X
Pharmacist
—
—
202C00000X
Independent Medical Examiner Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207SG0201X
Clinical Genetics (M.D.) Physician
—
—
251B00000X
Case Management Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0091733
WOLLCARE COMMUNITY HEALTH NETWORK
CA
Enumeration date
09/09/2022
Last updated
09/09/2022
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