Provider Demographics
NPI:1528819232
Name:RAMAN, ROMA A
Entity type:Individual
Prefix:
First Name:ROMA
Middle Name:A
Last Name:RAMAN
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 1:378 I ST
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-6088
Mailing Address - Country:US
Mailing Address - Phone:209-202-7707
Mailing Address - Fax:
Practice Address - Street 1:1116 ALICE ST
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-5905
Practice Address - Country:US
Practice Address - Phone:209-578-3132
Practice Address - Fax:209-578-3498
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)