Individual provider · Type 1 NPI

Monique Nellie Provencio

Clinical Social Worker · Stockton, CA

NPI number 1346618154 Active

Practice location

430 N Pilgrim St
Stockton, CA 95205-4428

Call (000) 000-0000 Map

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XASW136999 (CA)
Clinical Social Worker 1041C0700X150.118978 (IL)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1346618154

Monique Nellie Provencio's National Provider Identifier is 1346618154, issued on Sep 10, 2015. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Stockton, CA. The record was last updated on Feb 11, 2026.