Healthcare Provider Details

I. General information

NPI: 1134087588
Provider Name (Legal Business Name): JAXSEN BALL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAXSEN BALL RAMIREZ MD

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 UNIVERSITY AVE
RIVERSIDE CA
92521-0001
US

IV. Provider business mailing address

900 UNIVERSITY AVE BLDG II
RIVERSIDE CA
92521-9800
US

V. Phone/Fax

Practice location:
  • Phone: 951-827-9197
  • Fax: 951-827-7670
Mailing address:
  • Phone: 951-827-4618
  • Fax: 951-263-7238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: