Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PSY30829 | CA |
N | 103T00000X | Psychologist | PSY30829 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY30829 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY30829 | CA |
Y | 103G00000X | Clinical Psychologist | PSY30829 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY30829 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY30829 | CA |
N | 103TF0000X | Family Psychologist | PSY30829 | CA |
N | 103TM1800X | Intellectual & Developmental Disabilities | PSY30829 | CA |
N | 103TP2701X | Group Psychotherapist | PSY30829 | CA |
NPI | 1326449273 |
---|---|
Provider Name | Glenda Paola Ramos |
First Address | Rancho Cucamonga, CA 91730-3852 |
Second Address | Rancho Cucamonga, CA 91730 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2014 |
Last Update Date | 23/04/2020 |