Provider Demographics
NPI:1457908857
Name:RAMIREZ, SHERRY (PTA)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18133 RIDGEDALE DR
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-0115
Mailing Address - Country:US
Mailing Address - Phone:559-514-2304
Mailing Address - Fax:
Practice Address - Street 1:7077 N WEST AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-0669
Practice Address - Country:US
Practice Address - Phone:559-435-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50169225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant