Individual provider · Type 1 NPI

Luis Anthony Provencio

Addiction (Substance Use Disorder) Counselor · Bakersfield, CA

NPI number 1750691887 Active

Practice location

1018 21st St
Bakersfield, CA 93301-4709

Call (661) 861-9967 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1750691887

Luis Anthony Provencio's National Provider Identifier is 1750691887, issued on Oct 7, 2010. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Bakersfield, CA. The record was last updated on Oct 7, 2010.