Provider Demographics
NPI:1467940197
Name:HESS, RICHARD D JR (RN)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:D
Last Name:HESS
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4499 BRISBANE WAY UNIT 6
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-0650
Mailing Address - Country:US
Mailing Address - Phone:619-540-6405
Mailing Address - Fax:
Practice Address - Street 1:4499 BRISBANE WAY UNIT 6
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-0650
Practice Address - Country:US
Practice Address - Phone:619-540-6405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95048124163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse