Provider Demographics
NPI:1144628470
Name:RAMIREZ IBARRA, NIDYA Y
Entity type:Individual
Prefix:MISS
First Name:NIDYA
Middle Name:Y
Last Name:RAMIREZ IBARRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92033-0037
Mailing Address - Country:US
Mailing Address - Phone:760-747-6282
Mailing Address - Fax:
Practice Address - Street 1:240 S HICKORY ST STE 110
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4356
Practice Address - Country:US
Practice Address - Phone:760-747-6282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117868106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist