Provider Demographics
NPI:1396414249
Name:RAMIREZ, CASSANDRA JASMINE
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JASMINE
Last Name:RAMIREZ
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 1:380 COALINGA PLZ
Mailing Address - Street 2:
Mailing Address - City:COALINGA
Mailing Address - State:CA
Mailing Address - Zip Code:93210-1704
Mailing Address - Country:US
Mailing Address - Phone:855-343-1057
Mailing Address - Fax:844-563-6078
Practice Address - Street 1:380 COALINGA PLZ
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-1704
Practice Address - Country:US
Practice Address - Phone:855-343-1057
Practice Address - Fax:844-563-6078
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40916167G00000X, 167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician