Provider Demographics
NPI:1316585649
Name:RAMOS, BEVERLY ANNE
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY ANNE
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 SANTA DELPHINA AVE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-1713
Mailing Address - Country:US
Mailing Address - Phone:619-623-5776
Mailing Address - Fax:
Practice Address - Street 1:1151 SANTA DELPHINA AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-1713
Practice Address - Country:US
Practice Address - Phone:619-623-5776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013295363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily