Provider Demographics
NPI:1225436132
Name:RAMIREZ-TORRES, MARILYN MIREYA (LCSW)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:MIREYA
Last Name:RAMIREZ-TORRES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12137 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:91342-6031
Mailing Address - Country:US
Mailing Address - Phone:661-752-5137
Mailing Address - Fax:
Practice Address - Street 1:12137 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:LAKE VIEW TERRACE
Practice Address - State:CA
Practice Address - Zip Code:91342-6031
Practice Address - Country:US
Practice Address - Phone:661-752-5137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-09
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW69659104100000X
CALCSW1234991041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAASW69659OtherBOARD OF BEHAVIORAL SCIENCES