Provider Demographics
NPI:1366119117
Name:RAMIREZ, ANGELICA (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 EL PORTAL WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-5116
Mailing Address - Country:US
Mailing Address - Phone:408-393-9931
Mailing Address - Fax:
Practice Address - Street 1:17400 MONTEREY RD STE 2E
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-7319
Practice Address - Country:US
Practice Address - Phone:408-778-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22752225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist