Healthcare Provider Details

I. General information

NPI: 1154356939
Provider Name (Legal Business Name): JESSICA L RAMIREZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 FAIR RIDGE DR
FAIRFAX VA
22033-2906
US

IV. Provider business mailing address

3905 FAIR RIDGE DR
FAIRFAX VA
22033-2906
US

V. Phone/Fax

Practice location:
  • Phone: 703-772-2481
  • Fax: 702-772-1166
Mailing address:
  • Phone: 703-877-0584
  • Fax: 703-877-0592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202204269
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number0202204269
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: