PAUL LOUIS PROVENCIO

SAN DIEGO, CA
NPI1245562743
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
(Licence: CA  23582)
Enumeration Date2010-02-08
Last Update Date2010-02-08
Business Address
-- PAUL LOUIS PROVENCIO
9400 RUFFIN CT
SAN DIEGO, CA 92123-5300
Phone number: 858-514-4867
Mailing Address
-- PAUL LOUIS PROVENCIO
9400 RUFFIN CT
SAN DIEGO, CA 92123-5300
Phone number: 858-514-4867
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