Agency Information

PROVENCE FINANCIAL & INSURANCE SERVICES

Address:

9355 E STOCKTON BLVD

ELK GROVE, CA 95624

Phone

866-777-1035

URL:

Email:

insurancelicensing@acrisure.com

National Producer Number:

18274464

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	3214902	01/17/2017	Active	01/17/2017	01/31/2026
Non-Res. Surplus Lines Broker	3353409	07/10/2018	Active	07/10/2018	07/31/2024

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	01/17/2017	Active	01/17/2017
Health	07/26/2018	Active	07/26/2018
Life	07/26/2018	Active	07/26/2018
Property	01/17/2017	Active	01/17/2017
Surplus Lines	07/10/2018	Active	07/10/2018

Company Name	Appointment Type	Status	Active Date
119969
ALLIED INSURANCE COMPANY OF AMERICA	Casualty	Active	07/31/2018
	Property	Active	07/31/2018
1645
Company Name	Appointment Type	Status	Active Date
ALLIED PROPERTY AND CASUALTY INSURANCE COMPANY	Casualty	Active	07/31/2018
	Property	Active	07/31/2018
1646
Company Name	Appointment Type	Status	Active Date
AMCO INSURANCE COMPANY	Casualty	Active	07/31/2018
	Property	Active	07/31/2018
1717
Company Name	Appointment Type	Status	Active Date
AMERICAN CONTRACTORS INDEMNITY COMPANY	Casualty	Active	07/13/2018
1795
Company Name	Appointment Type	Status	Active Date
AMERICAN MODERN PROPERTY AND CASUALTY INSURANCE COMPANY	Casualty	Active	03/11/2019
	Property	Active	03/11/2019
1647
Company Name	Appointment Type	Status	Active Date
DEPOSITORS INSURANCE COMPANY	Casualty	Active	07/31/2018
	Property	Active	07/31/2018
1779
Company Name	Appointment Type	Status	Active Date
EMPLOYERS INSURANCE COMPANY OF NEVADA	Casualty	Active	11/24/2020
310
Company Name	Appointment Type	Status	Active Date
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY	Health	Active	06/24/2021
	Life	Active	06/24/2021
1379
Company Name	Appointment Type	Status	Active Date
HOMETOWN HEALTH PLAN INCORPORATED	Health	Active	10/15/2018
995
Company Name	Appointment Type	Status	Active Date
HOMETOWN HEALTH PROVIDERS INSURANCE COMPANY	Health	Active	10/15/2018
719
Company Name	Appointment Type	Status	Active Date
NATIONWIDE AFFINITY INSURANCE COMPANY OF AMERICA	Casualty	Active	07/31/2018
	Property	Active	07/31/2018
1236
Company Name	Appointment Type	Status	Active Date
NATIONWIDE AGRIBUSINESS INSURANCE COMPANY	Casualty	Active	07/31/2018
	Property	Active	07/31/2018
162
Company Name	Appointment Type	Status	Active Date
NATIONWIDE ASSURANCE COMPANY	Casualty	Active	09/21/2020
	Property	Active	09/21/2020
458
Company Name	Appointment Type	Status	Active Date
NATIONWIDE GENERAL INSURANCE COMPANY	Casualty	Active	09/10/2019
	Property	Active	09/10/2019
194
Company Name	Appointment Type	Status	Active Date
NATIONWIDE INSURANCE COMPANY OF AMERICA	Casualty	Active	07/31/2018
	Property	Active	07/31/2018
461
Company Name	Appointment Type	Status	Active Date
NATIONWIDE MUTUAL INSURANCE COMPANY	Casualty	Active	07/31/2018
	Property	Active	07/31/2018
1129
Company Name	Appointment Type	Status	Active Date
NATIONWIDE PROPERTY AND CASUALTY INSURANCE COMPANY	Casualty	Active	04/07/2021
	Property	Active	04/07/2021
1295
Company Name	Appointment Type	Status	Active Date
PHILADELPHIA INDEMNITY INSURANCE COMPANY	Casualty	Active	08/08/2019
	Property	Active	08/08/2019
1550
Company Name	Appointment Type	Status	Active Date
PROMINENCE HEALTHFIRST	Health	Active	10/16/2022
1792
Company Name	Appointment Type	Status	Active Date
PROMINENCE PREFERRED HEALTH INSURANCE COMPANY INC	Health	Active	10/16/2022
1399
Company Name	Appointment Type	Status	Active Date
U S SPECIALTY INSURANCE COMPANY	Casualty	Active	07/13/2018
1667
Company Name	Appointment Type	Status	Active Date
UNITED CONCORDIA INSURANCE COMPANY	Health	Active	08/01/2018

row(s) 1 - 36 of 36

Name	Association Type	Agent	Begin Date	End Date
IFFTIKHAR HUSSAIN WAHLA	Designated Resp Lic Prdcr	Yes	12/17/2022	-
JULIE ANN BAKER	Designated Resp Lic Prdcr	Yes	06/01/2020	-
MARIE DEBRA SCHRYER	Designated Resp Lic Prdcr	Yes	01/14/2021	-

1 - 3

PROVENCE FINANCIAL & INSURANCE SERVICES

Address:

Phone

URL:

Email:

National Producer Number:

ButtomHolder

License Information

Qual Information

22 Appointments

3 Individual Associations