Healthcare Provider Details

I. General information

NPI: 1699600809
Provider Name (Legal Business Name): ALBERT RAMIREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 5TH AVE
UPLAND CA
91786-4839
US

IV. Provider business mailing address

328 S SYCAMORE AVE
RIALTO CA
92376-6548
US

V. Phone/Fax

Practice location:
  • Phone: 909-949-6526
  • Fax:
Mailing address:
  • Phone: 909-265-6951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: