Provider Demographics
NPI:1144787425
Name:RAMOS, DEJA NICOLE (CD(DONA))
Entity Type:Individual
Prefix:
First Name:DEJA
Middle Name:NICOLE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4115 BERESFORD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-5149
Mailing Address - Country:US
Mailing Address - Phone:650-483-8478
Mailing Address - Fax:
Practice Address - Street 1:4115 BERESFORD ST APT 2
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-5149
Practice Address - Country:US
Practice Address - Phone:650-483-8478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA09778374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula