Provider Demographics
NPI:1942964929
Name:RAMOS, ANDREW JR
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:
Last Name:RAMOS
Suffix:JR
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 1:108 E HILLSDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2817
Mailing Address - Country:US
Mailing Address - Phone:650-796-9089
Mailing Address - Fax:650-345-2403
Practice Address - Street 1:108 E HILLSDALE BLVD
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2817
Practice Address - Country:US
Practice Address - Phone:650-796-9089
Practice Address - Fax:650-345-2403
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA415600593372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion