MARISA PROVENZANO

SAN DIEGO, CA
NPI1003707522
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  128960)
Enumeration Date2025-07-12
Last Update Date2025-07-12
Business Address
MARISA PROVENZANO LCSW
5060 SHOREHAM PL STE 100
SAN DIEGO, CA 92122-5904
Phone number: 877-840-6956
Mailing Address
MARISA PROVENZANO LCSW
3245 RANCHO MIGUEL RD
JAMUL, CA 91935-1907
Phone number: 619-847-2606
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