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Provider Information for 1316497274


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AZUCENA RAMIRES M.A.


Sex: Female

NPI: 1316497274
Last Updated: 2025-04-03
Certification Date: 2025-04-03

Details

NameValue
NPI1316497274
Enumeration Date2016-10-04
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1414 N CALIFORNIA ST
STOCKTON, CA 95202-1515
United States

Phone: 209-468-2385 | Fax:
 
Primary Practice Address 1414 N CALIFORNIA ST
STOCKTON, CA 95202-1515
United States

Phone: 209-468-2385 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)CA1012Medi-Cal
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101200000X - Drama Therapist CA153561