Healthcare Provider Details

I. General information

NPI: 1912752437
Provider Name (Legal Business Name): CRYSTAL RAMOS RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRYSTAL RAMOS RN, FNP

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 MOBIL AVE STE 19
CAMARILLO CA
93010-6301
US

IV. Provider business mailing address

323 MOBIL AVE STE 19
CAMARILLO CA
93010-6301
US

V. Phone/Fax

Practice location:
  • Phone: 805-330-0448
  • Fax:
Mailing address:
  • Phone: 805-330-0448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95249310
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95030188
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: