Healthcare Provider Details

I. General information

NPI: 1437039724
Provider Name (Legal Business Name): JASON RAMIREZ EALA DNP, APRN-RX, PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S BRADFORD ST STE 2
DOVER DE
19904-4153
US

IV. Provider business mailing address

95-390 KUAHELANI AVE # 3AC-1008
MILILANI HI
96789-1192
US

V. Phone/Fax

Practice location:
  • Phone: 302-592-3780
  • Fax: 302-291-1827
Mailing address:
  • Phone: 808-746-3664
  • Fax: 808-867-6537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-5431
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: