Individual provider Active NPI

Jessica Ramirez

  • Adult Health Nurse Practitioner
  • Huntington Park, CA
National Provider Identifier
1174099071
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
95010220 Issued in CA
Practice address
1900 E Slauson Ave Ste B
Huntington Park, CA 90255-2725
Phone
(767) 832-3277
NPI assigned
Oct 17, 2018
Last updated
Oct 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95010220 CA
Gerontology Nurse Practitioner 363LG0600X 95010220 CA
Adult Health Nurse Practitioner 363LA2200X 95010220 CA Primary

Addresses

Primary practice location

1900 E Slauson Ave Ste B
Huntington Park, CA 90255-2725

Mailing address

2040 Camfield Ave
Commerce, CA 90040-1574
Phone (323) 889-7830

Other practice location 1

3820 Martin Luther King Jr Blvd
Lynwood, CA 90262-3625
Phone (310) 632-0415

Other practice location 2

12130 Paramount Blvd
Downey, CA 90242-2339
Phone (562) 923-9414

Other practice location 3

1776 E Century Blvd
Los Angeles, CA 90002-3050
Phone (323) 374-6848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210310001648 CA Order and Referring Only - Nurse Practitioner 8820404254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95010220CAMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1174099071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 CAMFIELD AVE",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401574",
            "telephone_number": "323-889-7830",
            "fax_number": "323-201-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E SLAUSON AVE STE B",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902552725",
            "telephone_number": "767-832-3277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3820 Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "CA",
            "postal_code": "902623625",
            "country_code": "US",
            "telephone_number": "310-632-0415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12130 Paramount Blvd",
            "address_purpose": "LOCATION",
            "city": "Downey",
            "state": "CA",
            "postal_code": "902422339",
            "country_code": "US",
            "telephone_number": "562-923-9414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1776 E Century Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900023050",
            "country_code": "US",
            "telephone_number": "323-374-6848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95010220",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95010220",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95010220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

Verify at the official NPI Registry.