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NPI Code Detail

MEDICARE: DEMETRIA TREJO

MEDICARE:   DEMETRIA  TREJO
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 : 1396247631
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEMETRIA TREJO
Provider Business Mailing Address
First Line : 9109 ANCHOR COVE CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-2406
Country : US
Telephone Number : 702-937-9585
Fax Number :
Provider Business Practice Location Address
First Line : 801 S RANCHO DR STE E2B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-3812
Country : US
Telephone Number : 702-937-9585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2018
Last Update Date : 03/02/2018

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Directions to “ DEMETRIA TREJO ” Practice Location

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