Healthcare Provider Details

I. General information

NPI: 1386281731
Provider Name (Legal Business Name): LAURA RACHELL RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2019
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 E MORRIS AVE
MODESTO CA
95354-0437
US

IV. Provider business mailing address

2145 W SWEET WATER CT
MERCED CA
95348-3631
US

V. Phone/Fax

Practice location:
  • Phone: 209-558-7494
  • Fax: 209-558-8919
Mailing address:
  • Phone: 209-631-1778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number95364998
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number95364998
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95364998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: