Provider Demographics
NPI:1710184577
Name:HAVERKAMP, RITA MARIE (RN, CNS)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:MARIE
Last Name:HAVERKAMP
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Gender:F
Credentials:RN, CNS
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Other - First Name:
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Mailing Address - Street 1:8080 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-2104
Mailing Address - Country:US
Mailing Address - Phone:619-589-3313
Mailing Address - Fax:619-589-3260
Practice Address - Street 1:8080 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2104
Practice Address - Country:US
Practice Address - Phone:619-589-3313
Practice Address - Fax:619-589-3260
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult