Provider Demographics
NPI:1881241511
Name:TUCK, RICHELLE ASHTEN (RN)
Entity type:Individual
Prefix:
First Name:RICHELLE
Middle Name:ASHTEN
Last Name:TUCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4167 AVENIDA DE LA PLATA STE 105
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-6032
Mailing Address - Country:US
Mailing Address - Phone:760-520-6705
Mailing Address - Fax:
Practice Address - Street 1:2950 BEAR VALLEY PKWY S
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-7446
Practice Address - Country:US
Practice Address - Phone:760-717-8460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA846224163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool