Provider Demographics
NPI:1770379059
Name:HAUSKENS, ANN-ELISE
Entity type:Individual
Prefix:
First Name:ANN-ELISE
Middle Name:
Last Name:HAUSKENS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 RYAN RD APT 27
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-2635
Mailing Address - Country:US
Mailing Address - Phone:415-328-7318
Mailing Address - Fax:
Practice Address - Street 1:1756 LACASSIE AVE STE 101
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-7036
Practice Address - Country:US
Practice Address - Phone:925-433-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74206225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist