Healthcare Provider Details

I. General information

NPI: 1538668132
Provider Name (Legal Business Name): MARIA ELIZABETH RAMIREZ GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2018
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2667 CAMINO DEL RIO S STE 102
SAN DIEGO CA
92108-3763
US

IV. Provider business mailing address

5163 LA PAZ DR
SAN DIEGO CA
92114-5209
US

V. Phone/Fax

Practice location:
  • Phone: 619-782-0700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: