Healthcare Provider Details

I. General information

NPI: 1386844918
Provider Name (Legal Business Name): MS. CYNTHIA MARIE HOLLIS-FRANKLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. CYNTHIA MARIE HOLLIS-FRANKLIN

II. Dates (important events)

Enumeration Date: 07/22/2007
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 SANTA INEZ AVE APARTMENT 2
SAN BRUNO CA
94066-5257
US

IV. Provider business mailing address

157 SANTA INEZ AVE APARTMENT 2
SAN BRUNO CA
94066-5257
US

V. Phone/Fax

Practice location:
  • Phone: 650-871-7587
  • Fax:
Mailing address:
  • Phone: 650-871-7587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number513664
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number10111
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number580
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: