Provider Demographics
NPI:1568048791
Name:ARAGONA, JESSICA (MS, RDN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ARAGONA
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 W COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WALKER LAKE
Mailing Address - State:NV
Mailing Address - Zip Code:89415-9672
Mailing Address - Country:US
Mailing Address - Phone:775-316-1690
Mailing Address - Fax:
Practice Address - Street 1:1025 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SCHURZ
Practice Address - State:NV
Practice Address - Zip Code:89427
Practice Address - Country:US
Practice Address - Phone:775-773-2005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered