Provider Demographics
NPI:1992516389
Name:RAMIREZ, ILA NATALIE
Entity type:Individual
Prefix:
First Name:ILA
Middle Name:NATALIE
Last Name:RAMIREZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 VINEYARD RD APT 119
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-7813
Mailing Address - Country:US
Mailing Address - Phone:619-314-3008
Mailing Address - Fax:
Practice Address - Street 1:1529 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2464
Practice Address - Country:US
Practice Address - Phone:760-798-0299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner