Healthcare Provider Details

I. General information

NPI: 1720917990
Provider Name (Legal Business Name): JESSICA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 W OLYMPIC BLVD
LOS ANGELES CA
90015-3808
US

IV. Provider business mailing address

408 S SPRING ST APT 1003
LOS ANGELES CA
90013-2025
US

V. Phone/Fax

Practice location:
  • Phone: 323-433-4165
  • Fax:
Mailing address:
  • Phone: 760-333-7690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: