Provider Demographics
NPI:1457741472
Name:RAMIREZ, ROWENA
Entity Type:Individual
Prefix:
First Name:ROWENA
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 1:8302 FOSS LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:ANTELOPE
Mailing Address - State:CA
Mailing Address - Zip Code:95843-5941
Mailing Address - Country:US
Mailing Address - Phone:916-804-3071
Mailing Address - Fax:916-295-1474
Practice Address - Street 1:8302 FOSS LAKE WAY
Practice Address - Street 2:
Practice Address - City:ANTELOPE
Practice Address - State:CA
Practice Address - Zip Code:95843-5941
Practice Address - Country:US
Practice Address - Phone:916-804-3071
Practice Address - Fax:916-295-1474
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor