Provider Demographics
NPI:1225732548
Name:RAMIREZ, ANDREA CHARLENE (HIS)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CHARLENE
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:CHARLENE
Other - Last Name:TEMORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7055 N MAPLE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-8012
Mailing Address - Country:US
Mailing Address - Phone:559-593-1624
Mailing Address - Fax:209-577-8046
Practice Address - Street 1:937 COFFEE RD STE 100
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4240
Practice Address - Country:US
Practice Address - Phone:209-577-1014
Practice Address - Fax:209-577-8046
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8606237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist