Provencio, Monique Nellie

Provencio, Monique Nellie is an sole proprietor health care provider with primary practice located at 430 N Pilgrim St , Stockton CA 95205-4428. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Provencio, Monique Nellie can be contacted via phone (000) 000-0000.

Contact Information

Primary practice address
430 N Pilgrim St Stockton CA 95205-4428
Phone: (000) 000-0000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X ASW136999 California
Behavioral Health & Social Service Providers / Clinical 1041C0700X 150.118978 Illinois

Profile Details

NPI number 1346618154
LBN Legal business name Provencio, Monique Nellie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 10th, 2015
Last updated Feb 11th, 2026 - about 8 months 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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