Provider Demographics
NPI:1205994290
Name:RAMOS, BEVERLY JOY SANSON (MD)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JOY SANSON
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 21ST ST STE D
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-1672
Mailing Address - Country:US
Mailing Address - Phone:805-237-2609
Mailing Address - Fax:
Practice Address - Street 1:731 21ST ST STE D
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-1672
Practice Address - Country:US
Practice Address - Phone:805-237-2609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0672112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1124045042OtherNPI# PASO ROBLES
CAFHC70737FMedicaid
CAW1508OtherGROUP'S PTAN
CA1124045042OtherNPI# PASO ROBLES
CAW1508OtherGROUP'S PTAN