Provider Demographics
NPI:1891415014
Name:RAMIREZ, EVELYN CALDERON
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:CALDERON
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-4926
Mailing Address - Country:US
Mailing Address - Phone:559-675-7893
Mailing Address - Fax:
Practice Address - Street 1:1604 SUNRISE AVE
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-4926
Practice Address - Country:US
Practice Address - Phone:559-675-7893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA946000518OtherMEDI-CAL