Healthcare Provider Details

I. General information

NPI: 1508753450
Provider Name (Legal Business Name): ANNA LISA RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 RIVER OAKS PKWY
SAN JOSE CA
95134-1907
US

IV. Provider business mailing address

7205 RAINBOW DR APT E2
SAN JOSE CA
95129-4501
US

V. Phone/Fax

Practice location:
  • Phone: 408-914-3851
  • Fax:
Mailing address:
  • Phone: 510-306-1762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: