Provider Demographics
NPI:1336485796
Name:WILSON, FRANCELYN ESTAVILLO (LVN)
Entity Type:Individual
Prefix:
First Name:FRANCELYN
Middle Name:ESTAVILLO
Last Name:WILSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1873 BUCKSKIN GLN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-1155
Mailing Address - Country:US
Mailing Address - Phone:619-964-1971
Mailing Address - Fax:
Practice Address - Street 1:639 N ESCONDIDO BLVD
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-1701
Practice Address - Country:US
Practice Address - Phone:760-738-1926
Practice Address - Fax:760-738-1928
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA206554164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse