Provider Demographics
NPI:1578201869
Name:GASCH, RAMANA LINNEA
Entity Type:Individual
Prefix:
First Name:RAMANA
Middle Name:LINNEA
Last Name:GASCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAMANA
Other - Middle Name:
Other - Last Name:LINNEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 RULOFSON ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2518
Mailing Address - Country:US
Mailing Address - Phone:510-757-3690
Mailing Address - Fax:
Practice Address - Street 1:603 MISSION ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-3612
Practice Address - Country:US
Practice Address - Phone:831-600-7103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94024860390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program