Provider Demographics
NPI:1285191056
Name:RAMIREZ, JOSE VERNAVE
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:VERNAVE
Last Name:RAMIREZ
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 1:1480 ORO VISTA RD APT 113
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-4082
Mailing Address - Country:US
Mailing Address - Phone:619-735-4333
Mailing Address - Fax:
Practice Address - Street 1:1180 THIRD AVE STE C3
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-3139
Practice Address - Country:US
Practice Address - Phone:619-691-8164
Practice Address - Fax:619-426-2359
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)