Provider Demographics
NPI:1710513148
Name:RAUHAUSER, MARA MARIE (RN, PHN)
Entity Type:Individual
Prefix:MRS
First Name:MARA
Middle Name:MARIE
Last Name:RAUHAUSER
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9726 DUNBAR LN
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-2680
Mailing Address - Country:US
Mailing Address - Phone:619-504-3062
Mailing Address - Fax:
Practice Address - Street 1:9726 DUNBAR LN
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-2680
Practice Address - Country:US
Practice Address - Phone:619-504-3062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA545435163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse