Healthcare Provider Details

I. General information

NPI: 1013787977
Provider Name (Legal Business Name): KIMBERLY JIMENA RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 FOOTHILL BLVD
SUNLAND CA
91040-1925
US

IV. Provider business mailing address

8800 FOOTHILL BLVD
SUNLAND CA
91040-1925
US

V. Phone/Fax

Practice location:
  • Phone: 818-293-6350
  • Fax:
Mailing address:
  • Phone: 818-293-6350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number750772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: