Provider Demographics
NPI:1104277870
Name:RUELAS-RAMIREZ, MAYRA A
Entity type:Individual
Prefix:
First Name:MAYRA
Middle Name:A
Last Name:RUELAS-RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22248 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4005
Mailing Address - Country:US
Mailing Address - Phone:510-210-1028
Mailing Address - Fax:
Practice Address - Street 1:22248 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4005
Practice Address - Country:US
Practice Address - Phone:510-210-1028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator