Provider Demographics
NPI:1811986631
Name:RICKER, CHARITE NICOLETTE (MS,GCG)
Entity type:Individual
Prefix:MS
First Name:CHARITE
Middle Name:NICOLETTE
Last Name:RICKER
Suffix:
Gender:F
Credentials:MS,GCG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 EASTLAKE AVE
Mailing Address - Street 2:USCNORRIS CANCER HOSPITAL - GENETICS PROGRAM ROOM 1341
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-0177
Mailing Address - Country:US
Mailing Address - Phone:323-865-0911
Mailing Address - Fax:323-865-0933
Practice Address - Street 1:1441 EASTLAKE AVE
Practice Address - Street 2:USCNORRIS CANCER HOSPITAL - GENETICS PROGRAM ROOM 1341
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0177
Practice Address - Country:US
Practice Address - Phone:323-865-0911
Practice Address - Fax:323-865-0933
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS