Provider Demographics
NPI:1619414828
Name:RAMIREZ, KIMBERLY ANN (CADC-II)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:CADC-II
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AII2971214
Mailing Address - Street 1:43250 MIDNIGHT CT
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-9565
Mailing Address - Country:US
Mailing Address - Phone:951-922-1725
Mailing Address - Fax:951-922-1725
Practice Address - Street 1:43250 MIDNIGHT CT
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-9565
Practice Address - Country:US
Practice Address - Phone:951-922-1725
Practice Address - Fax:951-922-1725
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAII2971214101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)