Provider Demographics
NPI:1639937337
Name:RAMIREZ, ANTHONY ROMAN
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ROMAN
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 MOUNT TERMINUS DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2530
Mailing Address - Country:US
Mailing Address - Phone:619-539-0664
Mailing Address - Fax:
Practice Address - Street 1:8303 CLAIREMONT MESA BLVD STE 201202
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1326
Practice Address - Country:US
Practice Address - Phone:760-294-1206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician