Provider Demographics
NPI:1992841332
Name:RAMIREZ, MOSES (OTR)
Entity Type:Individual
Prefix:MR
First Name:MOSES
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 E CAMPBELL AVE STE 18
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2126
Mailing Address - Country:US
Mailing Address - Phone:408-559-1300
Mailing Address - Fax:
Practice Address - Street 1:621 E CAMPBELL AVE STE 18
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2126
Practice Address - Country:US
Practice Address - Phone:408-559-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT6983225X00000X
225XE1200X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOT0069830OtherBLUE SHIELD PPIN
CA5628915OtherFIRST HEALTH ID#
CAOT0069830OtherBLUE SHIELD PPIN