Healthcare Provider Details

I. General information

NPI: 1912818501
Provider Name (Legal Business Name): JOSIAH RAMIREZ SUDRC I
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 SALVIO ST STE 101
CONCORD CA
94520-6104
US

IV. Provider business mailing address

1342 VIVA LN
CONCORD CA
94518-1611
US

V. Phone/Fax

Practice location:
  • Phone: 925-444-0014
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number26018
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: