Healthcare Provider Details

I. General information

NPI: 1134868375
Provider Name (Legal Business Name): MELANIE AILYN RAMIREZ VALLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2022
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date: 07/23/2026
Reactivation Date: 08/11/2026

III. Provider practice location address

5280 E BEVERLY BLVD STE C
LOS ANGELES CA
90022-2044
US

IV. Provider business mailing address

5280 E BEVERLY BLVD STE C
LOS ANGELES CA
90022-2044
US

V. Phone/Fax

Practice location:
  • Phone: 310-384-5317
  • Fax: 310-943-3333
Mailing address:
  • Phone: 310-384-5317
  • Fax: 310-943-3333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number28979
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: