Individual
MYCHAEL SHAWN HAYSBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 N 4TH ST, SAN JOSE, CA 95112-5569
(669) 245-3429
Mailing address
210 N 4TH ST, SAN JOSE, CA 95112-5569
(669) 245-3429
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
CA
175T00000X
Peer Specialist
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
06/12/2024
Last updated
08/11/2026
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