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NPI Code Detail

MEDICARE: JESSIE XAVIER DIAZ

MEDICARE: JESSIE XAVIER DIAZ
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 AttendantNV

General Provider Information

NPI Number : 1508795212
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSIE XAVIER DIAZ
Provider Business Mailing Address
First Line : 1492 N LAMB BLVD APT 1021
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-1355
Country : US
Telephone Number : 725-204-4713
Fax Number :
Provider Business Practice Location Address
First Line : 1735 N NELLIS BLVD STE A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89115-3670
Country : US
Telephone Number : 725-204-4713
Fax Number : 725-204-4714
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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Directions to “ JESSIE XAVIER DIAZ ” Practice Location

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