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General NPI Number Information
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NPI Number | 1386246247
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Entity Type | Individual
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Provider Name | JESSICA D CARO
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Gender | Female
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Dates
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Enumeration Date | 11/14/2020
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Last Update Date | 11/14/2020
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Provider Practice Location Address
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Address Line | 90 GAULT WAY
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City | SPARKS
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State | NV
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Zip | 89431-2322
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Country | US
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Telephone | 775-356-5351
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Fax |
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Provider Business Mailing Address
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Address Line | 5672 WINWARD CIR
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City | SUN VALLEY
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State | NV
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Zip | 89433-7510
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Country | US
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Telephone | 775-815-8217
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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