Healthcare Provider Details

I. General information

NPI: 1114864840
Provider Name (Legal Business Name): FRANCINE NICOLE SAN NICOLAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29282 MENIFEE RD
MENIFEE CA
92584-7766
US

IV. Provider business mailing address

29282 MENIFEE RD
MENIFEE CA
92584-7766
US

V. Phone/Fax

Practice location:
  • Phone: 951-679-5285
  • Fax: 951-672-8651
Mailing address:
  • Phone: 951-679-5285
  • Fax: 951-672-8651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number698729
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: