Healthcare Provider Details

I. General information

NPI: 1417783606
Provider Name (Legal Business Name): RAMBEL BEHAVIORAL HEALTH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1671 W MAIN ST STE D
EL CENTRO CA
92243-5420
US

IV. Provider business mailing address

1671 W MAIN ST STE D
EL CENTRO CA
92243-5420
US

V. Phone/Fax

Practice location:
  • Phone: 760-592-7760
  • Fax: 760-592-7765
Mailing address:
  • Phone: 760-592-7760
  • Fax: 760-592-7765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN GUERREO
Title or Position: DIRECTOR
Credential: NP
Phone: 760-975-5305