Provider Demographics
NPI:1720647381
Name:FRANCILLON, LYDIE (MD)
Entity Type:Individual
Prefix:
First Name:LYDIE
Middle Name:
Last Name:FRANCILLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 EDWIN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-1915
Mailing Address - Country:US
Mailing Address - Phone:805-293-1653
Mailing Address - Fax:
Practice Address - Street 1:300 HILLMONT AVE
Practice Address - Street 2:BLDG 340, SUITE 201
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1651
Practice Address - Country:US
Practice Address - Phone:805-652-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL161358207Q00000X
CA181815207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine