Provider Demographics
NPI:1689978629
Name:RAMIREZ, RAFAEL RALPHY
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:RALPHY
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11329 MCLENNAN AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-3613
Mailing Address - Country:US
Mailing Address - Phone:818-270-3483
Mailing Address - Fax:
Practice Address - Street 1:11329 MCLENNAN AVE
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-3613
Practice Address - Country:US
Practice Address - Phone:818-270-3483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)