Provider Demographics
NPI:1679469324
Name:RAMIREZ-LARA, JORDAN ASHLEY (DC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ASHLEY
Last Name:RAMIREZ-LARA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 W AVENUE Q STE A
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3768
Mailing Address - Country:US
Mailing Address - Phone:661-272-1800
Mailing Address - Fax:661-272-9861
Practice Address - Street 1:790 W AVENUE Q STE A
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3768
Practice Address - Country:US
Practice Address - Phone:661-272-1800
Practice Address - Fax:661-272-9861
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC37277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor