Provider Demographics
NPI:1003201278
Name:RAMIREZ, LILIANA (SLP)
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 BUSINESS CENTER DR
Mailing Address - Street 2:SUITE 127
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3467
Mailing Address - Country:US
Mailing Address - Phone:909-890-9030
Mailing Address - Fax:909-890-4393
Practice Address - Street 1:500 N CENTRAL AVE
Practice Address - Street 2:SUITE 440
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3905
Practice Address - Country:US
Practice Address - Phone:818-549-9764
Practice Address - Fax:818-549-9767
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9534235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB233953Medicare PIN