Healthcare Provider Details

I. General information

NPI: 1619161320
Provider Name (Legal Business Name): MARCELA MACIEL-RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5835 S EASTERN AVE
COMMERCE CA
90040-4029
US

IV. Provider business mailing address

325 S OAK KNOLL AVE BLDG B5
PASADENA CA
91101-3418
US

V. Phone/Fax

Practice location:
  • Phone: 323-725-4627
  • Fax:
Mailing address:
  • Phone: 323-804-9790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number60165
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: