Healthcare Provider Details

I. General information

NPI: 1215652763
Provider Name (Legal Business Name): ANGELICA RAMIREZ MONTEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S PRATT AVE
CARSON CITY NV
89701-4730
US

IV. Provider business mailing address

882 GRANITE CT
CARSON CITY NV
89705-7111
US

V. Phone/Fax

Practice location:
  • Phone: 775-882-3945
  • Fax:
Mailing address:
  • Phone: 775-682-1408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: