Haven Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

HAVEN PHYSICAL THERAPY

Practice address

7974 Haven Ave
Suite 215
Rancho Cucamonga, CA 91730-3061

Phone

(909) 481-5304

Fax

(909) 481-5307

NPI assigned

May 23, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian Douglas Boekhout, PT

Title

President

Phone

(909) 481-5304

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114972627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE",
            "address_2": "SUITE 290",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303061",
            "telephone_number": "909-481-5304",
            "fax_number": "909-481-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE",
            "address_2": "SUITE 215",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303061",
            "telephone_number": "909-481-5304",
            "fax_number": "909-481-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOEKHOUT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-481-5304",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haven Family Medical Center Inc
• Haven Family Medical Center Inc.
• Haven Family Medical Center, Inc.
• Haven Medical Clinic
• Haven Orthopedics & Spine Institute Inc
• Haven Urgent Care
• Kaliyah Hawkins-Stewart
• Jenifer Hawkins
• Lauresha Zinatae Hawkins, LCSW
• Paulette Lynn Hawn

• Physical Therapy Clinic/Center in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.