Healthcare Provider Details

I. General information

NPI: 1578121729
Provider Name (Legal Business Name): DR. RAQUEL RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RAQUEL TENORIO

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 S BROADWAY STE 209
WALNUT CREEK CA
94596-5219
US

IV. Provider business mailing address

710 S BROADWAY STE 209
WALNUT CREEK CA
94596-5219
US

V. Phone/Fax

Practice location:
  • Phone: 925-295-4327
  • Fax:
Mailing address:
  • Phone: 925-295-4327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number4305
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number4305
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: