Healthcare Provider Details

I. General information

NPI: 1457976409
Provider Name (Legal Business Name): CLAUDIA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 04/21/2021
Certification Date: 04/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1646 S COURT ST
VISALIA CA
93277-4962
US

IV. Provider business mailing address

3707 E SHIELDS AVE
FRESNO CA
93726-7029
US

V. Phone/Fax

Practice location:
  • Phone: 559-625-8890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberSUDRC10897
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: