Healthcare Provider Details

I. General information

NPI: 1285568220
Provider Name (Legal Business Name): DEJAH RABON MEDICAL ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 BRIDGEFORD CT
HENDERSON NV
89011-2614
US

IV. Provider business mailing address

1326 WINTER SOLSTICE AVE
HENDERSON NV
89014-8829
US

V. Phone/Fax

Practice location:
  • Phone: 831-324-5060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: