Healthcare Provider Details

I. General information

NPI: 1578842183
Provider Name (Legal Business Name): DANIEL RAMOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2011
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 HIDDEN PINES WAY
SANTA MARIA CA
93458-1419
US

IV. Provider business mailing address

48 RAFAEL WAY
SAN LUIS OBISPO CA
93405-1524
US

V. Phone/Fax

Practice location:
  • Phone: 805-361-5805
  • Fax:
Mailing address:
  • Phone: 956-212-9131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number104955
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18671
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: