Provider Demographics
NPI:1043048846
Name:JOHNSTON, HAYDEN FARHA
Entity type:Individual
Prefix:
First Name:HAYDEN
Middle Name:FARHA
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N OAKLAND AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1646
Mailing Address - Country:US
Mailing Address - Phone:608-772-2891
Mailing Address - Fax:
Practice Address - Street 1:303 N OAKLAND AVE APT 7
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1646
Practice Address - Country:US
Practice Address - Phone:608-772-2891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program