Provider Demographics
NPI:1699108084
Name:SUAREZ, RAMON ENRIQUE
Entity type:Individual
Prefix:MR
First Name:RAMON
Middle Name:ENRIQUE
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1386 GALAXY DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-3454
Mailing Address - Country:US
Mailing Address - Phone:909-233-0927
Mailing Address - Fax:
Practice Address - Street 1:12 S SAN GORGONIO AVE STE 201
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-6015
Practice Address - Country:US
Practice Address - Phone:840-228-0304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA927601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical