Wild Souls Ranch
NPI #1104702570 in Fortuna, California
Provider Information
- NPI Number
- 1104702570
- Entity Type
- Organization
- Organization Name
- Wild Souls Ranch
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Aug 12, 2025
- Last Updated
- Oct 15, 2025
Practice Location
- Address
- 2870 NELSON LN
- City
- Fortuna
- State
- California
- ZIP Code
- 95540-1708
- Phone
- (707) 617-0356
Authorized Official
- Name
- MAYA JIMENEZ-OSELL
- Title
- EXECUTIVE DIRECTION
- Phone
- (707) 617-0356
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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