Individual
MR. JESSIE FRAGOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
11812 JULIUS AVE, DOWNEY, CA 90241-4612
(562) 659-4081
Mailing address
11812 JULIUS AVE, DOWNEY, CA 90241-4612
(562) 659-4081
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86045829
CA
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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