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NPI Code Detail

MEDICARE: MR. RAFAEL RAMIREZ MFT

MEDICARE: MR. RAFAEL RAMIREZ MFT
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
1106H00000XMarriage & Family Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ENK1304OTHERCAL.A. DEPT. MENTAL HEALTH

General Provider Information

NPI Number : 1538293618
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RAFAEL RAMIREZ MFT
Provider Business Mailing Address
First Line : 4063 CUDAHY ST
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-6853
Country : US
Telephone Number : 323-581-8904
Fax Number :
Provider Business Practice Location Address
First Line : 1000 GOODRICH BLVD
Second Line :
City : COMMERCE
State : CA
Zip : 90022-5103
Country : US
Telephone Number : 323-832-9795
Fax Number : 323-832-9796
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 07/08/2007

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