Healthcare Provider Details

I. General information

NPI: 1639301047
Provider Name (Legal Business Name): ADRIANA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2009
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E SHAW AVE STE 171
FRESNO CA
93710-7911
US

IV. Provider business mailing address

1040 N PLEASANT AVE
FRESNO CA
93728-2434
US

V. Phone/Fax

Practice location:
  • Phone: 559-472-6635
  • Fax:
Mailing address:
  • Phone: 559-899-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number106773
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: