Healthcare Provider Details

I. General information

NPI: 1346150679
Provider Name (Legal Business Name): SUSANA RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 QUAIL CT STE 102
WALNUT CREEK CA
94596-5564
US

IV. Provider business mailing address

33 QUAIL CT STE 102
WALNUT CREEK CA
94596-5564
US

V. Phone/Fax

Practice location:
  • Phone: 925-297-5515
  • Fax: 925-532-1853
Mailing address:
  • Phone: 925-297-5515
  • Fax: 925-532-1853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberL9766
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: