Healthcare Provider Details
I. General information
NPI: 1487985677
Provider Name (Legal Business Name): LETICIA RAMIREZ MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/27/2010
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1206 G ST STE 102
FRESNO CA
93706-1643
US
IV. Provider business mailing address
1206 G ST STE 102
FRESNO CA
93706-1643
US
V. Phone/Fax
- Phone: 559-459-0334
- Fax: 559-459-0339
- Phone: 559-459-0334
- Fax: 559-459-0339
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 376K00000X |
| Taxonomy | Nurse's Aide |
| License Number | 00538406 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: