Provider Demographics
NPI:1881424059
Name:HAILE, ALULA (NP)
Entity type:Individual
Prefix:
First Name:ALULA
Middle Name:
Last Name:HAILE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 BUSINESS CENTER DR STE 2001
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1001
Mailing Address - Country:US
Mailing Address - Phone:949-345-0461
Mailing Address - Fax:478-780-6088
Practice Address - Street 1:2102 BUSINESS CENTER DR STE 2001
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1001
Practice Address - Country:US
Practice Address - Phone:949-345-0461
Practice Address - Fax:478-780-6088
Is Sole Proprietor?:No
Enumeration Date:2024-08-03
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95028767363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health