Healthcare Provider Details

I. General information

NPI: 1750234688
Provider Name (Legal Business Name): LUPE DONNELLY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40971 WINCHESTER RD STE 2
TEMECULA CA
92591-6031
US

IV. Provider business mailing address

32672 JUNIPER BERRY DR
WINCHESTER CA
92596-8658
US

V. Phone/Fax

Practice location:
  • Phone: 951-404-4458
  • Fax:
Mailing address:
  • Phone: 951-306-9678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95033237
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: