Healthcare Provider Details

I. General information

NPI: 1568399475
Provider Name (Legal Business Name): MICHELLE RAMIREZ
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2780 DERRINGER PL
ESCONDIDO CA
92027-1897
US

IV. Provider business mailing address

2780 DERRINGER PL
ESCONDIDO CA
92027-1897
US

V. Phone/Fax

Practice location:
  • Phone: 858-472-1908
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW100269
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: