Healthcare Provider Details

I. General information

NPI: 1841121191
Provider Name (Legal Business Name): ADRIAN RAMIREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 PIPER ST APT 1
HEALDSBURG CA
95448-3974
US

IV. Provider business mailing address

207 PIPER ST APT 1
HEALDSBURG CA
95448-3974
US

V. Phone/Fax

Practice location:
  • Phone: 707-304-6404
  • Fax:
Mailing address:
  • Phone: 707-304-6404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number11900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: