Provider Demographics
NPI:1184934184
Name:RAMIREZ, RENE (OTR/L)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8795 LA RIVIERA DR APT 58
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-1825
Mailing Address - Country:US
Mailing Address - Phone:313-585-5872
Mailing Address - Fax:
Practice Address - Street 1:10535 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655-4200
Practice Address - Country:US
Practice Address - Phone:800-382-8387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-09
Last Update Date:2010-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11311225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist