Provider Demographics
NPI:1992984561
Name:RAMIREZ, SHANNAN CHERIE (AMFT)
Entity type:Individual
Prefix:
First Name:SHANNAN
Middle Name:CHERIE
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:SHANNAN
Other - Middle Name:CHERIE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1030
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95992-1030
Mailing Address - Country:US
Mailing Address - Phone:530-431-8074
Mailing Address - Fax:
Practice Address - Street 1:815 PLUMAS ST
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4437
Practice Address - Country:US
Practice Address - Phone:530-431-8074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT109782101YM0800X
CA4493174400000X
CALMFT126448106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4493OtherCAS