Provider Demographics
NPI:1518379312
Name:RAMIREZ, JUANITA R
Entity Type:Individual
Prefix:
First Name:JUANITA
Middle Name:R
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUANITA
Other - Middle Name:R
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA PSC-B
Mailing Address - Street 1:40 E MINARETS AVE
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93650-1239
Mailing Address - Country:US
Mailing Address - Phone:559-436-0482
Mailing Address - Fax:559-436-4650
Practice Address - Street 1:40 E MINARETS AVE
Practice Address - Street 2:
Practice Address - City:PINEDALE
Practice Address - State:CA
Practice Address - Zip Code:93650-1239
Practice Address - Country:US
Practice Address - Phone:559-436-0482
Practice Address - Fax:559-436-4650
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator