Provider Demographics
NPI:1699511212
Name:RAMIREZ, ALYSSA NEVAEH
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:NEVAEH
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 1:14333 BABCOCK RD APT 8107
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1057
Mailing Address - Country:US
Mailing Address - Phone:956-564-9485
Mailing Address - Fax:
Practice Address - Street 1:24200 W INTERSTATE 10
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1145
Practice Address - Country:US
Practice Address - Phone:210-263-9443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBACB1145894106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician