Provider Demographics
NPI:1528683703
Name:RAMIREZ, DIEGO ALEJANDRO (LCSW 132466)
Entity type:Individual
Prefix:
First Name:DIEGO
Middle Name:ALEJANDRO
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:LCSW 132466
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58967 BUSINESS CENTER DR
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-7308
Mailing Address - Country:US
Mailing Address - Phone:760-369-3130
Mailing Address - Fax:
Practice Address - Street 1:4075 NIELSON RD
Practice Address - Street 2:
Practice Address - City:PHELAN
Practice Address - State:CA
Practice Address - Zip Code:92371-8896
Practice Address - Country:US
Practice Address - Phone:760-868-5817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90537101YM0800X
CA1324661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health