Healthcare Provider Details

I. General information

NPI: 1952602732
Provider Name (Legal Business Name): ADELINA RAMIREZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 05/26/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2629 CLARENDON AVE FL 2
HUNTINGTON PARK CA
90255-4119
US

IV. Provider business mailing address

1000 GOODRICH BLVD
COMMERCE CA
90022-5103
US

V. Phone/Fax

Practice location:
  • Phone: 323-584-3700
  • Fax:
Mailing address:
  • Phone: 323-832-9795
  • Fax: 562-924-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number72587
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number91299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: