Basic Information
Provider Information
NPI: 1508358698
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMIREZ
FirstName: ANDREW
MiddleName: M.A.
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1563 MISSION ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941032543
CountryCode: US
TelephoneNumber: 4159696535
FaxNumber: 4156211033
Practice Location
Address1: 890 HAYES ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941172615
CountryCode: US
TelephoneNumber: 4157015100
FaxNumber: 4156211033
Other Information
ProviderEnumerationDate: 06/04/2018
LastUpdateDate: 06/04/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XR1288860218CAY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


Home