Provider Demographics
NPI:1265812671
Name:RAMIREZ, LUIS A SR (CERTIFICATE)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:A
Last Name:RAMIREZ
Suffix:SR
Gender:M
Credentials:CERTIFICATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 NORTH H ST. SUITE F
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436
Mailing Address - Country:US
Mailing Address - Phone:805-322-8014
Mailing Address - Fax:805-322-8015
Practice Address - Street 1:1133 N H ST STE F
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-8137
Practice Address - Country:US
Practice Address - Phone:805-322-8014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)