Healthcare Provider Details

I. General information

NPI: 1487047544
Provider Name (Legal Business Name): MARIA RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2015
Last Update Date: 03/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 POPLAR AVE
MODESTO CA
95354-0510
US

IV. Provider business mailing address

2032 LINDA WAY
CERES CA
95307-2527
US

V. Phone/Fax

Practice location:
  • Phone: 209-883-2027
  • Fax: 209-883-2028
Mailing address:
  • Phone: 209-552-5172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW60676
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: