MEDICARE: MR. FREDERICO RAMIREZ LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCS20285	CA

General Provider Information

NPI Number	:	1083773790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FREDERICO RAMIREZ LCSW

Provider Business Mailing Address
First Line	:	3124 INTERNATIONAL BLVD
Second Line	:	4TH FLOOR
City	:	OAKLAND
State	:	CA
Zip	:	94601-2902
Country	:	US
Telephone Number	:	510-434-5439
Fax Number	:	510-437-9574

Provider Business Practice Location Address
First Line	:	3124 INTERNATIONAL BLVD
Second Line	:	4TH FLOOR
City	:	OAKLAND
State	:	CA
Zip	:	94601-2902
Country	:	US
Telephone Number	:	510-434-5439
Fax Number	:	510-437-9574

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2006
Last Update Date	:	03/30/2017

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