Healthcare Provider Details

I. General information

NPI: 1528843141
Provider Name (Legal Business Name): IRATZE NAYELI RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58457 29 PALMS HWY STE 102A
YUCCA VALLEY CA
92284-5879
US

IV. Provider business mailing address

58457 29 PALMS HWY STE 102A
YUCCA VALLEY CA
92284-5879
US

V. Phone/Fax

Practice location:
  • Phone: 760-228-9657
  • Fax:
Mailing address:
  • Phone: 760-228-9657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-FHSWYU
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: