Provider Demographics
NPI:1497145460
Name:NELIDA E VAZQUEZ-RAMIREZ
Entity Type:Organization
Organization Name:NELIDA E VAZQUEZ-RAMIREZ
Other - Org Name:HEAL CHANGE THRIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NELIDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:VAZQUEZ-RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:818-533-2337
Mailing Address - Street 1:PO BOX 661004
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91066-1004
Mailing Address - Country:US
Mailing Address - Phone:818-533-2337
Mailing Address - Fax:
Practice Address - Street 1:440 E HUNTINGTON DR STE 360
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3765
Practice Address - Country:US
Practice Address - Phone:818-533-2337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20379103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty