Provider Demographics
NPI:1962726257
Name:RAMIREZ, MONICA (BS)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 304
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-0030
Mailing Address - Country:US
Mailing Address - Phone:707-422-0464
Mailing Address - Fax:707-422-0465
Practice Address - Street 1:490 CHADBOURNE RD
Practice Address - Street 2:SUITE A
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-9613
Practice Address - Country:US
Practice Address - Phone:707-422-0464
Practice Address - Fax:707-422-0465
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health