Provider Demographics
NPI:1487018941
Name:RAMOS, RESSIE D (NP)
Entity type:Individual
Prefix:
First Name:RESSIE
Middle Name:D
Last Name:RAMOS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RESSIE
Other - Middle Name:MANIQUIZ
Other - Last Name:CABRAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:PO BOX 9602
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91346-9602
Mailing Address - Country:US
Mailing Address - Phone:818-837-5559
Mailing Address - Fax:818-792-4793
Practice Address - Street 1:17909 SOLEDAD CANYON RD
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-3210
Practice Address - Country:US
Practice Address - Phone:661-250-5216
Practice Address - Fax:661-250-5285
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003619363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB256351Medicare PIN