Provider Demographics
NPI:1114810355
Name:RAMIREZ-REYNA, OLIVIA (MA,PPS)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:RAMIREZ-REYNA
Suffix:
Gender:F
Credentials:MA,PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 N CONYER ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-2509
Mailing Address - Country:US
Mailing Address - Phone:559-280-9979
Mailing Address - Fax:
Practice Address - Street 1:12623 AVENUE 416
Practice Address - Street 2:
Practice Address - City:OROSI
Practice Address - State:CA
Practice Address - Zip Code:93647-2017
Practice Address - Country:US
Practice Address - Phone:559-528-4731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230079510103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty