Healthcare Provider Details

I. General information

NPI: 1295539849
Provider Name (Legal Business Name): RAMOS HEALTH AND WELLNESS PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80553 INDIAN TRAIL
TWENTYNINE PALMS CA
92277
US

IV. Provider business mailing address

73839 GORGONIO DR UNIT 91
TWENTYNINE PALMS CA
92277-8806
US

V. Phone/Fax

Practice location:
  • Phone: 714-591-3601
  • Fax:
Mailing address:
  • Phone: 714-591-3601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JARED YOUNG
Title or Position: OWNER
Credential:
Phone: 714-591-3601