Healthcare Provider Details

I. General information

NPI: 1528661436
Provider Name (Legal Business Name): ANA ALICIA FRAGA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2020
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31938 TEMECULA PKWY # A337
TEMECULA CA
92592-6810
US

IV. Provider business mailing address

30978 MIRA LOMA DR # 92592
TEMECULA CA
92592-3240
US

V. Phone/Fax

Practice location:
  • Phone: 951-417-4032
  • Fax:
Mailing address:
  • Phone: 760-681-4499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95013511
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF08200002
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: