Healthcare Provider Details

I. General information

NPI: 1205338100
Provider Name (Legal Business Name): AMEIA ANN RAMIREZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMEIA ANN MATES

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7592 BROADWAY
LEMON GROVE CA
91945-1604
US

IV. Provider business mailing address

823 GATEWAY CENTER WAY
SAN DIEGO CA
92102-4541
US

V. Phone/Fax

Practice location:
  • Phone: 619-515-2550
  • Fax:
Mailing address:
  • Phone: 619-515-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number138608
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: