Provider Demographics
NPI:1821256538
Name:RICHE, ROSEMARIE NONE (RN)
Entity Type:Individual
Prefix:MISS
First Name:ROSEMARIE
Middle Name:NONE
Last Name:RICHE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ROSEMARIE
Other - Middle Name:NONE
Other - Last Name:HAECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:683 VIA ALHAMBRA UNIT O
Mailing Address - Street 2:
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-4574
Mailing Address - Country:US
Mailing Address - Phone:415-408-1105
Mailing Address - Fax:
Practice Address - Street 1:3350 LA JOLLA VILAGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0001
Practice Address - Country:US
Practice Address - Phone:858-552-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA440176163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse