Healthcare Provider Details

I. General information

NPI: 1235817784
Provider Name (Legal Business Name): ELIZABETH RAMIREZ PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2540 CARMICHAEL WAY
CARMICHAEL CA
95608-5314
US

IV. Provider business mailing address

8373 STANSBURY AVE
PANORAMA CITY CA
91402-3738
US

V. Phone/Fax

Practice location:
  • Phone: 916-482-0465
  • Fax:
Mailing address:
  • Phone: 818-926-5157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number10115
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number49939
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: