Provider Demographics
NPI:1326682725
Name:CINCO, PHOEBE FRANCE AGANA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:PHOEBE FRANCE
Middle Name:AGANA
Last Name:CINCO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 NODEN ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-6315
Mailing Address - Country:US
Mailing Address - Phone:619-882-6868
Mailing Address - Fax:
Practice Address - Street 1:228 NODEN ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-6315
Practice Address - Country:US
Practice Address - Phone:619-885-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-30
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95012735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily