Provider Demographics
NPI:1386281731
Name:RAMIREZ, LAURA RACHELL
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:RACHELL
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 1:2145 W SWEET WATER CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-3631
Mailing Address - Country:US
Mailing Address - Phone:209-631-1778
Mailing Address - Fax:
Practice Address - Street 1:421 E MORRIS AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-0437
Practice Address - Country:US
Practice Address - Phone:209-558-7494
Practice Address - Fax:209-558-8919
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95364998163WP0807X, 163WP0808X, 163W00000X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No175T00000XOther Service ProvidersPeer Specialist