Provider Demographics
NPI:1144533530
Name:RAMIREZ, OMAR ENRIQUE (LMFT)
Entity type:Individual
Prefix:MR
First Name:OMAR
Middle Name:ENRIQUE
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KAISER PLZ
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3610
Mailing Address - Country:US
Mailing Address - Phone:877-457-4772
Mailing Address - Fax:
Practice Address - Street 1:1525 E 103RD ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-3308
Practice Address - Country:US
Practice Address - Phone:323-564-7911
Practice Address - Fax:323-569-8527
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85880106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist