MEDICARE: CORINA RAMIREZ M.S.W., LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	ASW 15578	CA
2	1041C0700X	Clinical Social Worker	LCS24379	CA

General Provider Information

NPI Number	:	1003906975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORINA RAMIREZ M.S.W., LCSW

Provider Business Mailing Address
First Line	:	4701 E CESAR E CHAVEZ AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4701 E CESAR E CHAVEZ AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-1209
Country	:	US
Telephone Number	:	323-267-3400
Fax Number	:	323-260-5201

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	11/13/2014

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