PAUL LOUIS PROVENCIO (NPI# 1245562743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245562743 |
| Entity Type | Individual |
| Full Name | PAUL LOUIS PROVENCIO |
| Practice Address |
9400 Ruffin Ct San Diego CA 92123-5300 |
| Practice Telephone | 8585144867 |
| Mailing Telephone | 8585144867 |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2010-02-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 104100000X | Social Worker | 23582 | CA | Behavioral Health & Social Service Providers |
| Street Address |
9400 RUFFIN CT |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92123-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396847299 | Joan Sandra Gildin | Psychiatry & Neurology | 9400 Ruffin Ct, B, San Diego, CA 92123-5300 | 2006-09-01 |
| 1497361026 | Laura Anett Jimenez | Case Manager/Care Coordinator | 9400 Ruffin Ct, San Diego, CA 92123-5399 | 2020-09-18 |
| 1770104382 | Shaun Michael Higley | Marriage & Family Therapist | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2020-05-05 |
| 1841822350 | Jazmin Andrea Zavala | Case Manager/Care Coordinator | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2020-02-12 |
| 1679124267 | Katherine Winstead | Case Manager/Care Coordinator | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2019-09-25 |
| 1497309991 | Tanya Zazueta | Case Manager/Care Coordinator | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2019-08-01 |
| 1851943765 | Nancy Cooper | Registered Nurse | 9400 Ruffin Ct, San Diego, CA 92123-5399 | 2019-07-10 |
| 1639630577 | Mayra Rodriguez | Counselor | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2019-03-25 |
| 1598225948 | Ashley Lizbeth Lopez | Counselor | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2019-03-21 |
| 1205390820 | Stephanie Soto | Counselor | 9400 Ruffin Ct, San Diego, CA 92123-5300 | 2019-01-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087326 | Corina Lozano Manzo | Registered Nurse | 7436 Mission Center Road, San Diego, CA 92123 | 2020-09-10 |
| 1831703537 | Shannon Leigh Doolittle | Audiologist | 3020 Children's Way Mc5010, San Diego, CA 92123 | 2020-09-01 |
| 1861014359 | Ha Thanh Truong | Pharmacist | Rezcare, 3821 Calle Fortunada, San Diego, CA 92123 | 2020-05-07 |
| 1023667136 | Brittany Meyer | Physical Therapist | 3020 Children's Waymc5068, San Diego, CA 92123 | 2019-09-11 |
| 1598313272 | Ryan Edward Shaw | Marriage & Family Therapist | 8910 Clairmont Mesa Blvd, San Diego, CA 92123 | 2019-08-27 |
| 1528611910 | Tanisha C Fulcher | Marriage & Family Therapist | 8825 Aero Dr., Ste 315, San Diago, CA 92123 | 2019-07-24 |
| 1245795665 | Robin James Pekin | Marriage & Family Therapist | 4450 Kearny Villa Rd, #116, San Diego, CA 92123 | 2019-02-11 |
| 1174093728 | Karen Vences | Counselor | 8755 Aero Dr Suite 230, San Diego, CA 92123 | 2018-11-27 |
| 1255808465 | Natasha Herrera | Counselor | 2801 Meadow Lark Dr, San Diego, San Diego, CA 92123 | 2018-10-25 |
| 1407321987 | Maneka Elikewela | Behavior Technician | 3934 Murphy Canyon Rd, Ste B202, San Diego, CA 92123 | 2018-10-10 |
| Find all providers in zip 92123 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089868 | Kimberly J Hansen Anderson | Social Worker | 12071 Tivoli Park Row Unit 2, San Diego, CA 92128-4385 | 2020-09-30 |
| 1184189532 | Barbara Arriaga | Social Worker | 591 Camino De La Reina Ste 810, San Diego, CA 92108-3150 | 2019-02-08 |
| 1942672126 | Gretchen Penner | Social Worker | 2121 5th Ave Ste 214, San Diego, CA 92101-2139 | 2015-10-27 |
| 1821465105 | Kimberly Brownell | Social Worker | 969 Market St, Suite 503, San Diego, CA 92101-7209 | 2015-08-21 |
| 1689059545 | Stephanie Suggs | Social Worker | 3789 1/2 3rd Ave, San Diego, CA 92103-4102 | 2015-07-21 |
| 1659751667 | Adrianne Domingo | Social Worker | 8345 Kern Cres, San Diego, CA 92127-4111 | 2015-06-04 |
| 1205245917 | Devon Boone | Social Worker | 3427 4th Ave Fl 2, San Diego, CA 92103-4910 | 2014-08-06 |
| 1215363957 | Ellen B. Crowley | Social Worker | 5500 Overland Ave, Suite 430, San Diego, CA 92123-1202 | 2013-09-25 |
| 1134475072 | Kerri Zuba Kelly | Social Worker | 5560 Overland Ave, San Diego, CA 92123-1204 | 2012-07-30 |
| 1821365578 | Lindsay Artemisia Almanza | Social Worker | 3930 4th Ave Ste 300, San Diego, CA 92103-3119 | 2011-11-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.