Provider Demographics
NPI:1245419613
Name:POURMAND, RAMIKA (BA)
Entity Type:Individual
Prefix:
First Name:RAMIKA
Middle Name:
Last Name:POURMAND
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:RAMIKA
Other - Middle Name:
Other - Last Name:FAMILMOSHGOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-4604
Mailing Address - Country:US
Mailing Address - Phone:209-725-2125
Mailing Address - Fax:
Practice Address - Street 1:815 W 18TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-4604
Practice Address - Country:US
Practice Address - Phone:209-725-2125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health