Active NPI
Ralph C. Havens, P.T.
- Physical Therapist
- San Diego, CA
National Provider Identifier
1679798904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT13102
- Practice address
- 928 Fort Stockton Dr Ste 201
San Diego, CA 92103-1893 - Phone
- (619) 543-1470
- Fax
- (619) 543-1421
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT13102 | CA | Primary |
Addresses
Primary practice location
928 Fort Stockton Dr Ste 201
San Diego, CA 92103-1893
Mailing address
1134 10TH St
Bellingham, WA 98225-7049
Phone (360) 599-2217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mission Hills Physical Therapy | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- San Diego, CA
- NPI 1134344401
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748908800000",
"number": "1679798904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1134 10TH ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982257049",
"telephone_number": "360-599-2217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 FORT STOCKTON DR STE 201",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921031893",
"telephone_number": "619-543-1470",
"fax_number": "619-543-1421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVENS",
"first_name": "RALPH",
"middle_name": "C.",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2025-06-03",
"certification_date": "2025-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT13102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.