Provider Demographics
NPI:1417415118
Name:RAMOS, MONICA RAE (CADCII)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:RAE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 E ARROW HWY BLDG C
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4987
Mailing Address - Country:US
Mailing Address - Phone:909-452-4952
Mailing Address - Fax:
Practice Address - Street 1:1260 E ARROW HWY BLDG C
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4987
Practice Address - Country:US
Practice Address - Phone:909-452-4952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA050741118101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)