Healthcare Provider Details

I. General information

NPI: 1285820522
Provider Name (Legal Business Name): LAURA RAMOS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA RAMOS LCSW

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14112 S KINGSLEY DR
GARDENA CA
90249-3018
US

IV. Provider business mailing address

PO BOX 701
ALHAMBRA CA
91802-0701
US

V. Phone/Fax

Practice location:
  • Phone: 310-217-7312
  • Fax: 310-352-3111
Mailing address:
  • Phone: 562-243-3032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28746
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: