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Desiree Provencio
Addiction (Substance Use Disorder) Counselor in Santa Clarita, California
NPI 1205023447

Desiree Provencio is an Addiction (Substance Use Disorder) Counselor based in Santa Clarita, CA and is specialized in Addiction (Substance Use Disorder). Desiree Provencio practices in Santa Clarita, CA. The NPI Number for Desiree Provencio is 1205023447 and holds a License No. (California).

The current practice location address for Desiree Provencio is 24625 Arch St, Santa Clarita, CA and can be reached out via phone at 661-254-6630.

Location: 24625 Arch St, Santa Clarita, CA, 91350-2991
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205023447
Provider Name
Desiree Provencio
Credential
Provider Entity Type
Individual
Gender
Female
Address
24625 Arch St, Santa Clarita, CA, 91350-2991
Phone Number
661-254-6630
Fax Number
Provider Enumeration Date
10/02/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
24625 Arch St
City
Santa Clarita
State
California
Zip
91321-1111
Phone Number
661-254-6630
Fax Number
person
Provider Business Mailing Address Details
Address
24625 Arch St
City
Santa Clarita
State
California
Zip
91321-1111
Phone Number
661-254-6630
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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