Provider Demographics
NPI:1154574945
Name:RAMIREZ, LEONDRA DANETTE
Entity type:Individual
Prefix:
First Name:LEONDRA
Middle Name:DANETTE
Last Name: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 1:7333 MILWOOD AVE
Mailing Address - Street 2:APT. 9
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1633
Mailing Address - Country:US
Mailing Address - Phone:818-704-5688
Mailing Address - Fax:
Practice Address - Street 1:8745 PARTHENIA PL
Practice Address - Street 2:# 4
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-5166
Practice Address - Country:US
Practice Address - Phone:818-895-5002
Practice Address - Fax:818-895-5502
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9226101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)