Healthcare Provider Details

I. General information

NPI: 1396502373
Provider Name (Legal Business Name): ARACELI LIBIER PONCE RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14124 BUCHER AVE
SYLMAR CA
91342-1424
US

IV. Provider business mailing address

16600 SHERMAN WAY STE 178
VAN NUYS CA
91406-3875
US

V. Phone/Fax

Practice location:
  • Phone: 747-315-6060
  • Fax:
Mailing address:
  • Phone: 818-235-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: