Provider Demographics
NPI:1184988677
Name:RAMOS, JESSICA HOPE (CCC-A)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:HOPE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 205196
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-5196
Mailing Address - Country:US
Mailing Address - Phone:949-713-3998
Mailing Address - Fax:949-713-2931
Practice Address - Street 1:2399 E RIVERWALK DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-5481
Practice Address - Country:US
Practice Address - Phone:949-713-3998
Practice Address - Fax:949-713-2931
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1742231H00000X
IDAUD-2670231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist