Provider Demographics
NPI:1255876876
Name:RAMOS, THERESA
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:THERESA
Other - Middle Name:
Other - Last Name:RAMOS-AMBRIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5702 DA VINCI WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-2325
Mailing Address - Country:US
Mailing Address - Phone:916-346-3314
Mailing Address - Fax:
Practice Address - Street 1:811 GRAND AVE STE D
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-3466
Practice Address - Country:US
Practice Address - Phone:916-922-9868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health