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General NPI Number Information
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NPI Number | 1891332714
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Entity Type | Individual
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Provider Name | JONATHON PAUL RAMIREZ RADT
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Gender | Male
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Dates
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Enumeration Date | 12/10/2019
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 7328 MILTON AVE APT C
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City | WHITTIER
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State | CA
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Zip | 90602-1574
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Country | US
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Telephone | 562-320-1425
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Fax |
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Provider Business Mailing Address
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Address Line | 515 E 6TH ST FL 9
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City | LOS ANGELES
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State | CA
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Zip | 90021-1009
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Country | US
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Telephone | 213-529-0961
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R1366231019
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License Number State | CA
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