Provider Demographics
NPI:1346638756
Name:CASTILLORAMIREZ, ROSALBA
Entity Type:Individual
Prefix:
First Name:ROSALBA
Middle Name:
Last Name:CASTILLORAMIREZ
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 1:45325 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-3740
Mailing Address - Country:US
Mailing Address - Phone:760-296-9534
Mailing Address - Fax:
Practice Address - Street 1:45325 BIRCH ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-3740
Practice Address - Country:US
Practice Address - Phone:760-296-9534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health