Healthcare Provider Details

I. General information

NPI: 1578050811
Provider Name (Legal Business Name): JOSHUA JACOB RAMIREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2018
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 DONALD DR
HOLLISTER CA
95023-6309
US

IV. Provider business mailing address

PO BOX 181
HOLLISTER CA
95024-0181
US

V. Phone/Fax

Practice location:
  • Phone: 831-636-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number125511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: