Provider Demographics
NPI:1972735165
Name:HAFKENSCHEID, CATHERINE JUDITH (RN,CPN)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:JUDITH
Last Name:HAFKENSCHEID
Suffix:
Gender:F
Credentials:RN,CPN
Other - Prefix:MS
Other - First Name:KATIE
Other - Middle Name:JUDTIH
Other - Last Name:HAFKENSCHEID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN,CPN
Mailing Address - Street 1:2680 STANBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1233
Mailing Address - Country:US
Mailing Address - Phone:562-421-2329
Mailing Address - Fax:562-354-6000
Practice Address - Street 1:2680 STANBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1233
Practice Address - Country:US
Practice Address - Phone:562-421-2329
Practice Address - Fax:562-354-6000
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA495622163WC0200X, 163WM0705X, 163WN0002X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care