Provider Demographics
NPI:1285007948
Name:JENNIFER KATES RAMLO, PH.D
Entity Type:Organization
Organization Name:JENNIFER KATES RAMLO, PH.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE-PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:SUZANNE KATES
Authorized Official - Last Name:RAMLO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-386-9664
Mailing Address - Street 1:15720 VENTURA BLVD STE 225
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2975
Mailing Address - Country:US
Mailing Address - Phone:818-386-9664
Mailing Address - Fax:
Practice Address - Street 1:15720 VENTURA BLVD STE 225
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2975
Practice Address - Country:US
Practice Address - Phone:818-386-9664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 19934103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA660040OtherVALUE OPTIONS