Provider Demographics
NPI:1659170801
Name:RAMIREZ, ISAAC
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50173 CALLE MARBELLA
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-5542
Mailing Address - Country:US
Mailing Address - Phone:442-256-3145
Mailing Address - Fax:
Practice Address - Street 1:50173 CALLE MARBELLA
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-5542
Practice Address - Country:US
Practice Address - Phone:442-225-6314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)