Healthcare Provider Details

I. General information

NPI: 1962829382
Provider Name (Legal Business Name): BLOOM BEHAVIORAL & EDUCATIONAL SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1842 LOCKHILL SELMA RD STE 102
SAN ANTONIO TX
78213-1559
US

IV. Provider business mailing address

1150 N LOOP 1604 W STE 108-411
SAN ANTONIO TX
78248-4552
US

V. Phone/Fax

Practice location:
  • Phone: 210-643-1119
  • Fax: 210-910-6881
Mailing address:
  • Phone: 210-643-1119
  • Fax: 210-910-6881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: TRACI ERIN NICOLE RAMOS
Title or Position: BEHAVIOR ANALYST
Credential: M.ED., BCBA
Phone: 210-643-1119