MEDICARE: LISA RAMOS THERAPY

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1942191903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LISA RAMOS THERAPY

Provider Business Mailing Address
First Line	:	260 S SYCAMORE AVE APT 4
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-3052
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	260 S SYCAMORE AVE APT 4
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-3052
Country	:	US
Telephone Number	:	310-480-1900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LISA RAMOS
Credential	:	LMFT
Telephone Number	:	310-480-1900

Provider Enumeration Date	:	07/09/2025
Last Update Date	:	07/09/2025

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