Healthcare Provider Details

I. General information

NPI: 1265812671
Provider Name (Legal Business Name): LUIS A. RAMIREZ SR. CERTIFICATE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2015
Last Update Date: 06/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 N H ST STE F
LOMPOC CA
93436-8137
US

IV. Provider business mailing address

1133 NORTH H ST. SUITE F
LOMPOC CA
93436
US

V. Phone/Fax

Practice location:
  • Phone: 805-322-8014
  • Fax:
Mailing address:
  • Phone: 805-322-8014
  • Fax: 805-322-8015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: