Provider Demographics
NPI:1154159572
Name:RAMIREZ, ANGELICA CRUZ (ADS STUDENT)
Entity type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:CRUZ
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:ADS STUDENT
Other - Prefix:MRS
Other - First Name:ANGELICA
Other - Middle Name:
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ADS STUDENT
Mailing Address - Street 1:4470 OJAI RD
Mailing Address - Street 2:
Mailing Address - City:SANTA PAULA
Mailing Address - State:CA
Mailing Address - Zip Code:93060-9681
Mailing Address - Country:US
Mailing Address - Phone:805-766-5270
Mailing Address - Fax:
Practice Address - Street 1:1911 WILLIAMS DR STE 210
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2612
Practice Address - Country:US
Practice Address - Phone:805-981-1422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker