=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376604876
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NANCY RAMOS LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2006
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6822 HEMP CT
-----------------------------------------------------
City | QUARTZ HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93536-3817
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-943-4546
-----------------------------------------------------
Fax | 661-272-2784
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6822 HEMP CT
-----------------------------------------------------
City | QUARTZ HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93536-3817
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-943-4546
-----------------------------------------------------
Fax | 661-272-2784
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LCS 22921
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------