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WILD SOULS RANCH
NPI 1104702570
Community/Behavioral Health in Fortuna, CA

Active since August 12, 2025
2870 NELSON LN, FORTUNA, CA 95540(707) 617-0356 Get Directions Write a Review

NPPES record last updated: October 15, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Wild Souls Ranch NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILD SOULS RANCH (NPI 1104702570) is a healthcare organization registered as a community/behavioral health in Fortuna, California and active in the NPI registry since August 2025. The organization lists Maya Jimenez-osell, Executive Direction, as its authorized official.

NPPES Registry Identity

NPI1104702570
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameWILD SOULS RANCH
Location Address2870 NELSON LNFortuna, CA 95540-1708
Mailing Address2870 Nelson LnFortuna, CA 95540-1708 · (707) 617-0356
Phone(707) 617-0356
Organization SubpartNo
Authorized OfficialMaya Jimenez-osellExecutive Direction · (707) 617-0356
Enumeration DateAugust 12, 2025
Last NPPES UpdateOctober 15, 2025
NPPES CertifiedOctober 15, 2025
✔ NPI 1104702570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
2870 NELSON LN, Fortuna, CA 95540
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLARE EDWARDS BCBA
Behavior Analyst
2870 NELSON LN
FORTUNA, CA 95540
Humboldt County (707) 502-4017

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wild Souls Ranch's NPI number?

The NPI number for Wild Souls Ranch is 1104702570. It was assigned to this organization in the NPPES registry on August 12, 2025.

Where is Wild Souls Ranch located?

Wild Souls Ranch is located at 2870 Nelson Ln, Fortuna, CA 95540. The listed phone number is (707) 617-0356.

What is Wild Souls Ranch's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Wild Souls Ranch was last updated on October 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.