Healthcare Provider Details

I. General information

NPI: 1053531343
Provider Name (Legal Business Name): MARIA ASCENCION RAMOS BRACAMONTES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 E BEACH ST
WATSONVILLE CA
95076-4809
US

IV. Provider business mailing address

1000A, 1010C EMELINE AVE.
SANTA CRUZ CA
95060-1900
US

V. Phone/Fax

Practice location:
  • Phone: 831-728-0222
  • Fax: 831-707-2777
Mailing address:
  • Phone: 831-425-0112
  • Fax: 831-425-1847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number235969
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: