KRYSTEN PROVENCIO

LAGUNA HILLS, CA
NPI1770350761
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  65129)
Enumeration Date2023-12-08
Last Update Date2026-06-28
Business Address
KRYSTEN PROVENCIO PA-C
24012 CALLE DE LA PLATA STE 330
LAGUNA HILLS, CA 92653-7624
Phone number: 949-829-5533
Mailing Address
KRYSTEN PROVENCIO PA-C
2995 RED HILL AVE STE 200
COSTA MESA, CA 92626-5984
Phone number: 949-829-5533
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