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General NPI Number Information
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NPI Number | 1174099071
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Entity Type | Individual
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Provider Name | JESSICA RAMIREZ
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Gender | Female
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Dates
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Enumeration Date | 10/17/2018
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Last Update Date | 10/17/2018
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Provider Practice Location Address
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Address Line | 1900 E SLAUSON AVE STE B
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-2725
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Country | US
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Telephone | 767-832-3277
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 CAMFIELD AVE
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City | COMMERCE
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State | CA
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Zip | 90040-1574
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Country | US
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Telephone | 323-889-7830
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Fax | 323-201-3218
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95010220
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 95010220
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95010220
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License Number State | CA
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