Provider Demographics
NPI:1053652818
Name:RAMIREZ HERRERA, LORENA D (AOD)
Entity Type:Individual
Prefix:MISS
First Name:LORENA
Middle Name:D
Last Name:RAMIREZ HERRERA
Suffix:
Gender:F
Credentials:AOD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 Q AVE
Mailing Address - Street 2:4
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-4935
Mailing Address - Country:US
Mailing Address - Phone:619-606-5229
Mailing Address - Fax:
Practice Address - Street 1:1212 S 43RD ST
Practice Address - Street 2:SUITE C
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-3434
Practice Address - Country:US
Practice Address - Phone:619-263-7768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARI-R1206262012101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)