Provider Demographics
NPI:1861859308
Name:RAMOS, GERARDO III
Entity Type:Individual
Prefix:MR
First Name:GERARDO
Middle Name:
Last Name:RAMOS
Suffix:III
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 1:422 E HERMOSA ST APT A
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-3765
Mailing Address - Country:US
Mailing Address - Phone:805-406-3968
Mailing Address - Fax:
Practice Address - Street 1:422 E HERMOSA ST APT A
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-3765
Practice Address - Country:US
Practice Address - Phone:805-406-3968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker