Provider Demographics
NPI:1255863064
Name:DE LEON, MICHELLE FRANCIS (RN, PHN)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:FRANCIS
Last Name:DE LEON
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48360 PECHANGA RD
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-2986
Mailing Address - Country:US
Mailing Address - Phone:951-676-6810
Mailing Address - Fax:
Practice Address - Street 1:48360 PECHANGA RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-2986
Practice Address - Country:US
Practice Address - Phone:951-676-6810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA836061163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health