Provider Demographics
NPI:1164300760
Name:RAMIREZ RAZO, LAURA JACQUELINE
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JACQUELINE
Last Name:RAMIREZ RAZO
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 1:2937 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-3042
Mailing Address - Country:US
Mailing Address - Phone:323-841-2658
Mailing Address - Fax:
Practice Address - Street 1:2023 S WESTGATE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6118
Practice Address - Country:US
Practice Address - Phone:310-899-9597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician