Provider Demographics
NPI:1851070247
Name:NAVARRO RAMIREZ, ELIANETH JAZMIN
Entity Type:Individual
Prefix:
First Name:ELIANETH
Middle Name:JAZMIN
Last Name:NAVARRO RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIANETH
Other - Middle Name:JAZMIN
Other - Last Name:RAMIREZ PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12966 EUCLID ST STE 280
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-9202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17862 17TH ST STE 107
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2170
Practice Address - Country:US
Practice Address - Phone:714-661-5390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116480104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker