Provider Demographics
NPI:1164797916
Name:MUNIZ, RONNIE
Entity Type:Individual
Prefix:
First Name:RONNIE
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5015 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-2311
Mailing Address - Country:US
Mailing Address - Phone:415-822-1585
Mailing Address - Fax:415-822-6443
Practice Address - Street 1:5015 THIRD STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124
Practice Address - Country:US
Practice Address - Phone:415-822-1585
Practice Address - Fax:415-822-6443
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)