Provider Demographics
NPI:1851656094
Name:RAMOS, SAMUEL OVED (MA, BCBA)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:OVED
Last Name:RAMOS
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19528 VENTURA BLVD # 283
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2917
Mailing Address - Country:US
Mailing Address - Phone:818-312-7592
Mailing Address - Fax:818-831-1700
Practice Address - Street 1:17134 DEVONSHIRE ST
Practice Address - Street 2:# 101
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1601
Practice Address - Country:US
Practice Address - Phone:818-360-5564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-11-9670103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst