Provider Demographics
NPI:1528591997
Name:RAMIREZ, ANGEL JR (SERVICE COORDINATOR)
Entity Type:Individual
Prefix:MR
First Name:ANGEL
Middle Name:
Last Name:RAMIREZ
Suffix:JR
Gender:M
Credentials:SERVICE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4741 ENGLE RD
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-2223
Mailing Address - Country:US
Mailing Address - Phone:916-977-0949
Mailing Address - Fax:916-483-6326
Practice Address - Street 1:4741 ENGLE RD
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-2223
Practice Address - Country:US
Practice Address - Phone:916-977-0949
Practice Address - Fax:916-483-6326
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor