Provider Demographics
NPI:1760679278
Name:NUNNINK, FRANCEL CARACOL (DC)
Entity Type:Individual
Prefix:
First Name:FRANCEL
Middle Name:CARACOL
Last Name:NUNNINK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1362 SUNSET DRIVE
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509
Mailing Address - Country:US
Mailing Address - Phone:925-706-0323
Mailing Address - Fax:925-706-2319
Practice Address - Street 1:1362 SUNSET DRIVE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-706-0323
Practice Address - Fax:925-706-2319
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC023083111N00000X
CA418645163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0230830OtherBLUE SHIELD OF CA
U64469Medicare UPIN
DC0230830OtherBLUE SHIELD OF CA