Healthcare Provider Details

I. General information

NPI: 1306344338
Provider Name (Legal Business Name): FRANCES MARTINEZ ABILA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 01/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9731 MAGNOLIA AVE
RIVERSIDE CA
92503-3609
US

IV. Provider business mailing address

9731 MAGNOLIA AVE
RIVERSIDE CA
92503-3609
US

V. Phone/Fax

Practice location:
  • Phone: 951-688-7411
  • Fax: 951-688-7412
Mailing address:
  • Phone: 951-688-7411
  • Fax: 951-688-7412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number801875
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number801875
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: