Provider Demographics
NPI:1417680109
Name:PONCE RAMOS, XOCHITL
Entity Type:Individual
Prefix:
First Name:XOCHITL
Middle Name:
Last Name:PONCE 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 1:2118 WILLOW PASS RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2414
Mailing Address - Country:US
Mailing Address - Phone:510-329-7230
Mailing Address - Fax:
Practice Address - Street 1:2118 WILLOW PASS RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2408
Practice Address - Country:US
Practice Address - Phone:510-329-7230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)