Healthcare Provider Details
I. General information
NPI: 1285912147
Provider Name (Legal Business Name): CHRYSTAL RAMOS MFTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/26/2011
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
327 S K ST
TULARE CA
93274-5416
US
IV. Provider business mailing address
327 S K ST
TULARE CA
93274-5416
US
V. Phone/Fax
- Phone: 559-688-2043
- Fax: 559-688-1304
- Phone: 559-688-2043
- Fax: 559-688-1304
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 82368 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: