Healthcare Provider Details

I. General information

NPI: 1740383520
Provider Name (Legal Business Name): RITA CAMPBELL RN, CMSPMH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4715 VIEWRIDGE AVE STE 230
SAN DIEGO CA
92123-1680
US

IV. Provider business mailing address

2818 ASHFORD OAK DR
HOUSTON TX
77082-2113
US

V. Phone/Fax

Practice location:
  • Phone: 800-257-8715
  • Fax: 800-819-1655
Mailing address:
  • Phone: 281-752-7088
  • Fax: 281-752-5098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number228644
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: