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1215691118
CELINA PROVENCIO
SAN FRANCISCO, CA
NPI
1215691118
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2021-10-26
Last Update Date
2023-10-05
Business Address
CELINA PROVENCIO
2205 POST ST
SAN FRANCISCO, CA 94115-3427
Phone number: 415-390-6511
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Mailing Address
CELINA PROVENCIO
1654 151ST AVE
SAN LEANDRO, CA 94578-1956
Phone number: 520-240-5118
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