Provider Demographics
NPI:1326504788
Name:RAMIREZ, MELINDA MARIE (RADT)
Entity Type:Individual
Prefix:
First Name:MELINDA MARIE
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RADT
Other - Prefix:
Other - First Name:MELINDA MARIE
Other - Middle Name:
Other - Last Name:DEL HARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:795 WILLOW RD BLDG 332
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-2539
Mailing Address - Country:US
Mailing Address - Phone:650-324-1470
Mailing Address - Fax:650-324-4149
Practice Address - Street 1:795 WILLOW RD BLDG 332
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-2539
Practice Address - Country:US
Practice Address - Phone:650-324-1470
Practice Address - Fax:650-324-4149
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1307210518101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)