Provider Demographics
NPI:1033681838
Name:RAMLO, JENNIFER SUZANNE KATES (PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:SUZANNE KATES
Last Name:RAMLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15720 VENTURA BLVD.
Mailing Address - Street 2:SUITE 225
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436
Mailing Address - Country:US
Mailing Address - Phone:818-386-9664
Mailing Address - Fax:
Practice Address - Street 1:15720 VENTURA BLVD.
Practice Address - Street 2:SUITE 225
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:818-386-9664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19934103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist