Provider Demographics
NPI:1215194675
Name:RAMOS, JENEL (PSYD)
Entity Type:Individual
Prefix:
First Name:JENEL
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E ASHTABULA ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-4306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21518 BLANCO ROAD
Practice Address - Street 2:SUITE 105, ROOM 7
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260
Practice Address - Country:US
Practice Address - Phone:210-660-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36798103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical