Provider Demographics
NPI:1760906416
Name:RAMOS, NICHOLAS ARTHUR
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:ARTHUR
Last Name:RAMOS
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 1:255 N D ST STE 412
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401-1715
Mailing Address - Country:US
Mailing Address - Phone:951-788-5905
Mailing Address - Fax:
Practice Address - Street 1:255 N D ST STE 412
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1715
Practice Address - Country:US
Practice Address - Phone:951-788-5905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1225351828OtherMEDI CAL