Healthcare Provider Details

I. General information

NPI: 1730870502
Provider Name (Legal Business Name): DESTANI RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27211 TYRRELL AVE
HAYWARD CA
94544-4509
US

IV. Provider business mailing address

313 W WINTON AVE
HAYWARD CA
94544-1136
US

V. Phone/Fax

Practice location:
  • Phone: 510-670-7610
  • Fax:
Mailing address:
  • Phone: 510-887-0152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number142671
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: