Provider Demographics
NPI:1386844918
Name:HOLLIS-FRANKLIN, CYNTHIA MARIE
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:MARIE
Last Name:HOLLIS-FRANKLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:MARIE
Other - Last Name:HOLLIS-FRANKLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:157 SANTA INEZ AVE
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-5257
Mailing Address - Country:US
Mailing Address - Phone:650-871-7587
Mailing Address - Fax:
Practice Address - Street 1:157 SANTA INEZ AVE
Practice Address - Street 2:APARTMENT 2
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-5257
Practice Address - Country:US
Practice Address - Phone:650-871-7587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-22
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA513664163WC1500X
CA10111363LA2200X
CA580364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health