Individual ProviderStephanie Janice HolleyRegistered NurseNursing Service ProvidersPractice Address490 N Grape St, Escondido, CA 92025-3079(760) 975-9939PECOS EnrollmentBased on the most recent information from CMS, provider Stephanie Janice Holley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1003699083Provider TypeIndividualFull NameHolley, Stephanie JaniceGenderFemaleSole ProprietorYesEnumeration Date8/15/2023Last Updated2/12/2026Contact InformationPractice LocationPractice Address490 N Grape St, Escondido, CA 92025-3079Phone(760) 975-9939FaxUnlisted FaxMailing LocationMailing Address490 N Grape St, Escondido, CA 92025-3079Phone(760) 975-9939FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicenseRN95304279California