Healthcare Provider Details

I. General information

NPI: 1033974340
Provider Name (Legal Business Name): RICARDO NAVARRO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 BAYONET CIR
MARINA CA
93933-4600
US

IV. Provider business mailing address

17 LUNSFORD DR APT 4A
SALINAS CA
93906-4038
US

V. Phone/Fax

Practice location:
  • Phone: 831-384-7251
  • Fax:
Mailing address:
  • Phone: 831-676-8692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: