Search › California › 1041C0700X
Sean Provencio
NPI 1083508857 · on the registry since 2025 · sole proprietor
Practice
- Address
- 617 S Hudson Ave
Pasadena, CA 91106 - Phone
- (626) 808-5784
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-06-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California