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1154176584
JULIANA PROVENCIO
LA JOLLA, CA
NPI
1154176584
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-04-19
Last Update Date
2024-04-19
Business Address
JULIANA PROVENCIO
10666 N TORREY PINES RD
LA JOLLA, CA 92037-1027
Phone number: 858-554-3200
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Mailing Address
JULIANA PROVENCIO
10790 RANCHO BERNARDO RD # 4S-205
SAN DIEGO, CA 92127-5705
Phone number: 858-554-3200
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