Individual
ALLEN HAYSBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.A.T.C.
Contact information
Practice address
720 S B ST, SAN MATEO, CA 94401
(650) 579-7881
Mailing address
231 N CLAREMONT ST # 2, SAN MATEO, CA 94401-1825
(650) 344-2867
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
200342
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200342
CALIFORNIA ASSOCIATION OF ALCOHOL & DRUG EDUCATORS
CA
Enumeration date
07/06/2011
Last updated
07/06/2011
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