MEDICARE: RICHELLE BORNALES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	95335432	CA
2	163WM0705X	Medical-Surgical Registered Nurse	95335432	CA
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1295572436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHELLE BORNALES

Provider Business Mailing Address
First Line	:	3912 RUSTIC LN
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95688-9762
Country	:	US
Telephone Number	:	917-513-7667
Fax Number	:

Provider Business Practice Location Address
First Line	:	3912 RUSTIC LN
Second Line	:
City	:	VACAVILLE
State	:	CA
Zip	:	95688-9762
Country	:	US
Telephone Number	:	917-513-7667
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	07/15/2024

Similar Medicare Providers

1558245688 — WARDA HARCHAOUI
Practice Location Address:

542 MAIN STREET
VACAVILLE, CA
95688

Practice Phone: 707-358-2928
Practice Fax:

1679572176 — CITY OF VACAVILLE
Practice Location Address:

650 MERCHANT ST
VACAVILLE, CA
95688-6908

Practice Phone: 707-449-5452
Practice Fax:

1245230424 — WENDY WIGMORE
Practice Location Address:

506 MAIN ST
VACAVILLE, CA
95688-3912

Practice Phone: 707-446-7014
Practice Fax: 707-446-1871

1255332227 — DR. ROBERT CHARLES JACOBY M.D,
Practice Location Address:

1 QUALITY DR
VACAVILLE, CA
95688-9494

Practice Phone: 707-624-2810
Practice Fax:

1124011689 — ETHAN GEOFFREY HARRIS M.D.
Practice Location Address:

1119 E MONTE VISTA AVE
VACAVILLE, CA
95688-3009

Practice Phone: 707-469-4610
Practice Fax:

1255325577 — DR. CRYSTAL L HNATKO D.O.
Practice Location Address:

1 QUALITY DR
VACAVILLE, CA
95688-9494

Practice Phone: 707-651-2549
Practice Fax:

Directions to “ RICHELLE BORNALES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.