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NPI Code Detail

MEDICARE: JESSICA YVETTE IXCAJOC BERMUDEZ

MEDICARE: JESSICA YVETTE IXCAJOC BERMUDEZ
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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609374107
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA YVETTE IXCAJOC BERMUDEZ
Provider Business Mailing Address
First Line : 1951 STELLA LAKE ST STE 36
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2144
Country : US
Telephone Number : 702-888-1415
Fax Number :
Provider Business Practice Location Address
First Line : 1951 STELLA LAKE ST STE 36
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-2144
Country : US
Telephone Number : 702-888-1415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2018
Last Update Date : 01/30/2018

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Directions to “ JESSICA YVETTE IXCAJOC BERMUDEZ ” Practice Location

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