Healthcare Provider Details

I. General information

NPI: 1619705944
Provider Name (Legal Business Name): ASHLEY KATHRINA RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 EDMONDS RD. BLDG. B
REDWOOD CITY CA
94062
US

IV. Provider business mailing address

6800 MISSION ST APT 301
DALY CITY CA
94014-2086
US

V. Phone/Fax

Practice location:
  • Phone: 209-955-2364
  • Fax:
Mailing address:
  • Phone: 650-274-3594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number735410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: