Individual
BETTY JEAN FRAGA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3109 E WHITMORE AVE, CERES, CA 95307-2906
(209) 541-2929
Mailing address
1833 KRUGER DR, MODESTO, CA 95355-3841
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP10026
CA
Other
Enumeration date
03/29/2006
Last updated
07/08/2007
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