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General NPI Number Information
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NPI Number | 1679798904
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Entity Type | Individual
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Provider Name | RALPH C. HAVENS P.T.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 928 FORT STOCKTON DR STE 201
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City | SAN DIEGO
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State | CA
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Zip | 92103-1893
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Country | US
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Telephone | 619-543-1470
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Fax | 619-543-1421
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Provider Business Mailing Address
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Address Line | 1134 10TH ST
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City | BELLINGHAM
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State | WA
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Zip | 98225-7049
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Country | US
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Telephone | 360-599-2217
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT13102
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License Number State | CA
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