Provencio, Desiree

Provencio, Desiree is an sole proprietor health care provider with primary practice located at 24625 Arch St , Santa Clarita CA 91321-1111. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Provencio, Desiree can be contacted via phone (661) 254-6630.

Contact Information

Primary practice address
24625 Arch St Santa Clarita CA 91321-1111
Phone: (661) 254-6630
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1205023447
LBN Legal business name Provencio, Desiree
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2007
Last updated Oct 2nd, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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