Provider Demographics
NPI:1376364687
Name:RAMIREZ, RITA
Entity type:Individual
Prefix:MRS
First Name:RITA
Middle Name:
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 1:13718 CAVERN CT APT SUITE
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-7513
Mailing Address - Country:US
Mailing Address - Phone:760-900-5605
Mailing Address - Fax:
Practice Address - Street 1:13718 CAVERN CT APT SUITE
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92394-7513
Practice Address - Country:US
Practice Address - Phone:760-900-5605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-19
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician