Provider Demographics
NPI:1275518821
Name:RAMIREZ, JESUS I (MD, MSW)
Entity type:Individual
Prefix:DR
First Name:JESUS
Middle Name:I
Last Name:RAMIREZ
Suffix:
Gender:
Credentials:MD, MSW
Other - Prefix:DR
Other - First Name:J
Other - Middle Name:
Other - Last Name:ZEUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MSW
Mailing Address - Street 1:2915 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2133
Mailing Address - Country:US
Mailing Address - Phone:530-867-0695
Mailing Address - Fax:
Practice Address - Street 1:2915 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2133
Practice Address - Country:US
Practice Address - Phone:530-867-0695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71020208600000X, 2086S0102X, 2086S0127X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I30037Medicare UPIN