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NPI Code Detail

MEDICARE: CANDY HERNANDEZ FRAGA

MEDICARE: CANDY HERNANDEZ FRAGA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1003701798
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDY HERNANDEZ FRAGA
Provider Business Mailing Address
First Line : 1662 SHADOW MOUNTAIN PL
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-2415
Country : US
Telephone Number : 702-913-9009
Fax Number :
Provider Business Practice Location Address
First Line : 6830 W OQUENDO RD STE 203
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-2551
Country : US
Telephone Number : 702-802-3585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2025
Last Update Date : 06/11/2025

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Directions to “ CANDY HERNANDEZ FRAGA ” Practice Location

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