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General NPI Number Information
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NPI Number | 1932775426
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Entity Type | Individual
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Provider Name | SANJAY RAJIVKUMAR RAMRATTAN
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Gender | Male
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 1202 MORENA BLVD STE 300
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City | SAN DIEGO
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State | CA
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Zip | 92110-3844
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Country | US
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Telephone | 619-275-0822
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Fax |
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Provider Business Mailing Address
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Address Line | 28504 COLHARY CT
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-5316
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Country | US
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Telephone | 661-433-2651
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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