Healthcare Provider Details

I. General information

NPI: 1558132431
Provider Name (Legal Business Name): JESUS ARTURO RIVERA RAMIREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 S ANITA DR
ORANGE CA
92868-3355
US

IV. Provider business mailing address

265 S ANITA DR
ORANGE CA
92868-3355
US

V. Phone/Fax

Practice location:
  • Phone: 949-749-2500
  • Fax:
Mailing address:
  • Phone: 949-749-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: