Healthcare Provider Details

I. General information

NPI: 1770407298
Provider Name (Legal Business Name): KACIE ELIZABETH RAMIREZ-DUQUE SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19772 MACARTHUR BLVD STE 200
IRVINE CA
92612-2405
US

IV. Provider business mailing address

1940 E 16TH ST APT O206
NEWPORT BEACH CA
92663-5966
US

V. Phone/Fax

Practice location:
  • Phone: 657-478-8334
  • Fax:
Mailing address:
  • Phone: 657-478-8334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number9768
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: