Basic Information
Provider Information
NPI: 1346802972
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMIREZ
FirstName: MARGARITA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 311 E MERCED ST
Address2:  
City: FOWLER
State: CA
PostalCode: 936252316
CountryCode: US
TelephoneNumber: 5598929452
FaxNumber:  
Practice Location
Address1: 311 E MERCED ST
Address2:  
City: FOWLER
State: CA
PostalCode: 936252316
CountryCode: US
TelephoneNumber: 5598929452
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/03/2019
LastUpdateDate: 11/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  N Behavioral Health & Social Service ProvidersCounselor 
101YA0400X106773CAN Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YM0800X106773CAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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