Healthcare Provider Details

I. General information

NPI: 1265796619
Provider Name (Legal Business Name): PEPE A RAMIREZ MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2012
Last Update Date: 06/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 MT HARVARD ST
BRIGHTON CO
80601-6559
US

IV. Provider business mailing address

4433 MT HARVARD ST
BRIGHTON CO
80601-6559
US

V. Phone/Fax

Practice location:
  • Phone: 951-285-5987
  • Fax: 303-637-7252
Mailing address:
  • Phone: 951-285-5987
  • Fax: 303-637-7252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: