Provider Demographics
NPI:1114300886
Name:HAUER-BEAGHLER, RICKIE (RD)
Entity type:Individual
Prefix:
First Name:RICKIE
Middle Name:
Last Name:HAUER-BEAGHLER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:RICKIE
Other - Middle Name:
Other - Last Name:HAUER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:3291 LOMA VISTA RD
Mailing Address - Street 2:BLDG. 340, SUITE 302
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3099
Mailing Address - Country:US
Mailing Address - Phone:805-652-6255
Mailing Address - Fax:
Practice Address - Street 1:3291 LOMA VISTA RD
Practice Address - Street 2:BLDG. 340, SUITE 302
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3099
Practice Address - Country:US
Practice Address - Phone:805-652-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered