Healthcare Provider Details

I. General information

NPI: 1700052180
Provider Name (Legal Business Name): LETY RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 ENBORG CT UNIT 100
SAN JOSE CA
95128-2645
US

IV. Provider business mailing address

871 ENBORG CT UNIT 100
SAN JOSE CA
95128-2645
US

V. Phone/Fax

Practice location:
  • Phone: 408-793-2147
  • Fax: 408-885-5376
Mailing address:
  • Phone: 408-793-2147
  • Fax: 408-885-5376

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: