Provider Demographics
NPI:1376928408
Name:RAMOS, JENNIFER DORIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DORIA
Last Name:RAMOS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2638 E. FLORENCE AVENUE
Mailing Address - Street 2:
Mailing Address - City:HUNGTINTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4708
Mailing Address - Country:US
Mailing Address - Phone:323-581-4665
Mailing Address - Fax:323-581-0551
Practice Address - Street 1:1936 E ANAHEIM ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3908
Practice Address - Country:US
Practice Address - Phone:562-599-2248
Practice Address - Fax:562-599-8801
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001745363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily