Provider Demographics
NPI:1265150833
Name:RAMIREZ, ANGELICA NATALIA
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:NATALIA
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 N HIGHLAND AVE APT 31
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-1437
Mailing Address - Country:US
Mailing Address - Phone:619-748-5290
Mailing Address - Fax:
Practice Address - Street 1:1127 S 38TH ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-3210
Practice Address - Country:US
Practice Address - Phone:619-262-4002
Practice Address - Fax:619-263-2230
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12568101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)