Provider Demographics
NPI:1952880155
Name:RAMIREZ, KORI RENEE (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:KORI
Middle Name:RENEE
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3320
Mailing Address - Country:US
Mailing Address - Phone:707-621-2540
Mailing Address - Fax:
Practice Address - Street 1:7 3RD ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3320
Practice Address - Country:US
Practice Address - Phone:707-621-2540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP22278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14111572OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
CASP22278OtherSPEECH-LANGUAGE PATHOLOGY AUDIOLOGY AND HEARING DISPENSERS BOARD