Healthcare Provider Details

I. General information

NPI: 1790174761
Provider Name (Legal Business Name): RAMON JOCOM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2015
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 WASHINGTON BLVD
WHITTIER CA
90602-1006
US

IV. Provider business mailing address

8428 E KENDRA LOOP
ORANGE CA
92867-1505
US

V. Phone/Fax

Practice location:
  • Phone: 532-698-0811
  • Fax: 562-789-5902
Mailing address:
  • Phone: 714-325-1773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95001904
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95001904
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95001904
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: