Rusty Razon

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95035001 Issued in CA

Practice address

6930 Beach Blvd
Suite L-141 PMB 1007
Buena Park, CA 90621

Phone

(626) 848-6417

Fax

(714) 276-2604

NPI assigned

Apr 20, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health and Nursing PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Anaheim, CA
  • NPI 1528693579
  Medicare reassignment NPD
• RCMH, Nursing Corporation

  • Psychiatric/Mental Health Nurse Practitioner
  • Cypress, CA
  • NPI 1043187776
  NPD (past)

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1710620430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6930 BEACH BLVD",
            "address_2": "SUITE L-141 PMB 1007",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "90621",
            "fax_number": "714-276-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6930 BEACH BLVD",
            "address_2": "SUITE L-141 PMB 1007",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "90621",
            "telephone_number": "626-848-6417",
            "fax_number": "714-276-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZON",
        "first_name": "RUSTY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-20",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95035001",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95188168",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ave Pauline San Luis Ramos, RN
• Mirna Ofelia Ramos, FNP-C
• Randall T Kanemaki DDS Inc
• Lauren Randall-Pelayo
• Shane Magbual Rayos del Sol, MD
• Richard Reamico, NP
• Recovercare Therapy Group, Inc.
• Jodie Reddingius Tintorer, PPS
• Reflex Physical Therapy and Rehab Inc.
• Rehabilitation Center of Orange County LLC

• Psychiatric/Mental Health Nurse Practitioner in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.