Healthcare Provider Details

I. General information

NPI: 1528591997
Provider Name (Legal Business Name): ANGEL RAMIREZ JR. SERVICE COORDINATOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 06/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4741 ENGLE RD
CARMICHAEL CA
95608-2223
US

IV. Provider business mailing address

4741 ENGLE RD
CARMICHAEL CA
95608-2223
US

V. Phone/Fax

Practice location:
  • Phone: 916-977-0949
  • Fax: 916-483-6326
Mailing address:
  • Phone: 916-977-0949
  • Fax: 916-483-6326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: