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Paul Provencio
NPI 1245562743 · on the registry since 2010
Practice
- Address
- 9400 Ruffin Ct
San Diego, CA 92123 - Phone
- (858) 514-4867
- Organisation at this address
- Fred Finch Youth Center
Promises2kids Foundation
Polinsky Children'S Center
Polinsky Day Rehabilitation
Rady Children'S Hospital San DiegoInferred from a shared address, not stated in the registry. - Clinicians at this address
- 92
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2010-02-08
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